雷米芬太尼与丙泊酚复合麻醉应用于腹腔镜胃肠穿孔修补术的临床研究

目的:探讨雷米芬太尼与丙泊酚复合麻醉在腹腔镜胃肠穿孔修补术的应用价值。方法:随机将2010年1月至2011年6月74例腹腔镜胃肠穿孔修补术患者分为两组,实验组术中予以雷米芬太尼、丙泊酚复合麻醉,对照组予以芬太尼麻醉。对比分析两组患者麻醉前、插管后即刻、插管后5 min、手术开始后10 min、拔管后即刻的平均动脉压(mean arterial pressure,MAP)与心率(heart rate,HR)变化、术后麻醉恢复情况,以及术后呼吸恢复时间、意识恢复时间、拔管时间等。结果:插管后即刻、插管后5 min、手术开始后10 min,实验组MAP、HR均小于对照组(P<0.05);术后呼吸恢复时间、意识恢复时间、拔管时间均优于对照组(P<0.05)。结论:腹腔镜胃肠穿孔修补术中应用雷米芬太尼复合丙泊酚麻醉在阻断手术刺激、维持循环稳定方面优于芬太尼,值得推广应用。

Clinical research of combined anesthesia with remifentanil and propofol for laparoscopic repair of gastrointestinal perforation

Objective:To investigate the application value of combined anesthesia with remifentanil and propofol for laparoscopic repair of gastrointestinal perforation.Methods:Seventy-four patients with gastrointestinal perforation who underwent laparoscopic repair from Jan.2010 to Jun.2011 were randomly divided into the experimental group and control group.Patients in experimental group were given remifentanil and propofol combined anesthesia,and patients in control group were given fentanyl.Mean arterial pressure(MAP) and heart rate(HR) before and 0,and 5 min after intubation,10 min after the beginning of surgery and 0 min after extubation,recovery time of respiration and consciousness,and the extubation time were comparatively analyzed.Results:The MAP and HR in the experimental group 0,and 5 min after intubation,and 10 min after the beginning of surgery were lower than those in the control group(P<0.05).Recovery time of respiration and consciousness,and the extubation time in the experimental group was shorter than that in the control group(P<0.05).Conclusions:Combined anesthesia with remifentanil and propofol in laparoscopic repair of gastrointestinal perforation is better than fentanyl in blocking surgical stimulation and maintaining circulation stabilization,and it is worthy of clinical application.