瑞芬太尼-丙泊酚靶控输注麻醉与瑞芬太尼-七氟醚麻醉用于腹腔镜胆囊手术的比较

目的 比较瑞芬太尼-丙泊酚靶控输注麻醉和瑞芬太尼七氟醚麻醉用于腹腔镜胆囊切除术(laparoscopic chdecystectomy,LC)对患者血流动力学及术后苏醒的影响.方法 48例行择期LC患者,年龄21岁～73岁,ASA Ⅰ级～Ⅱ级,采用完全随机的设计分为2组:瑞芬太尼-丙泊酚靶控输注麻醉组(RP组,n=24)和瑞芬太尼七氟醚维持麻醉组(RP组,n=24).分别记录2组手术期间麻醉用药维持量,麻醉过程各时点的平均动脉压(MAP)和心率(HR)及术毕患者苏醒各时段时间.结果 RP组与RS组血流动力学变化差异无统计学意义(P>0.05).苏醒时间RS组(7.0±3.4)min比RP组(13.1±7.8)min明显缩短(P<0.01).结论 七氟醚-端芬太尼维持麻醉与丙泊酚-瑞芬太尼靶控输注麻醉对患者术中血流动力学效应相当,然而七氟醚-瑞芬太尼维持麻醉患者苏醒更快,更适合用于快通道麻醉.

Comparison of remifentanil-propofol and remifentanil-sevoflurane anaesthesia for laparoscopic cholecystectomy

Objective To examine recovery profile and haemodynamic differences using remifentanil infusion with either propofol target controlled infusion system or sevoflurane inhalation for laparoscopic choleeystectomy. Methods Forty-eight adult patients, ASAⅠ～Ⅱgrade, undergoing elective laparoseopie cholecystectomy were randomly divided into two groups(n=24). Group R P received propofol target controlled infusion system and remifentanil; Group RS received sevoflurane and remifentanil for maintenance of anaesthesia. The amount of narcotie medication during the oporation, mean arterial pressure (MAP) and heart rate (HR) at each time point during anesthesia and awake time for patients after surgery of the two grous were recorded. Results No statistically significant differences between the two groups with tegards to the haemodynamic changes(P>O.05). Recovery times were considerably shorter after remifentanil-sevoflurane (7.0±3.4)min in comparison with remifentanil-prpofol (13.1±7.8) min target controlled infusion system group (P<0.01). Conclusion Remifentanil-propofol and sevoflurane-remifentanil combinations provide a similar adequate haemodynamic stability. However, sevoflurane-remifentanil gives a faster recovery compared with propofol target controlled infusion system with remifentanil for laparoscopic cholecystectomy.