丙泊酚和瑞芬太尼全静脉麻醉与丙泊酚和异氟醚静吸复合麻醉在腹腔镜手术中的对比观察(1)
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【摘要】目的评价以丙泊酚和瑞芬太尼全静脉麻醉对腹腔镜手术患者的应激反应的影响。方法将100例ASAI-Ⅱ级的腹腔镜胆囊切除患者随机分成两组(丙泊酚、瑞芬太尼维持为A组,丙泊酚、异氟醚维持为B组),每组50例。分别记录两组麻醉前、气腹后即刻、气腹后20 min和术毕的平均动脉压(MAP)、心率(HR)及 末梢血糖(Glu)。结果气腹后即刻A组MAP、HR显著低于B组(P<0.01);末梢血糖在气腹后20 min及术毕显著低于B组(P<0.05)。结论以丙泊酚和瑞芬太尼的全静脉麻醉较之以丙泊酚、异氟醚的静吸复合麻醉用于腹腔镜手术能更有效地抑制术中二氧化碳气腹所致的应激反应。
【关键词】
腹腔镜手术;瑞芬太尼;丙泊酚;全静脉麻醉;异氟醚;静吸复合麻醉
Compare Propofol combined with Remifentanil total intravenous anaesthesia with Propofol combined with isoflurane infusion-intravenous undergoing laparoscopic operation
LI Zhi-ping,SHI Hai-yan,ZHANGg Shu.Anesthesia department People’s Hospital of Dongguan,Guangdong,Dongguan 523018,China
【Abstract】ObjectiveTo evaluation the effects of immune status from Compare propofol combined with remifentanil total intravenous anaesthesia undergoing laparoscopic operation.Methods100 ASA I~II patients undergoing cysticolithby laparoscopic were randomly allocated into 2 groups(n=50);Group A:propofol combined with remifentanil total intravenous anaesthesia; Group B:propofol combined with isoflurane infusion-intravenous anaesthesia.MAP、HR and Blood Glue of before anaesthesia、pneumoperitoneum immediately、20 min after pneumoperitoneum and postoperative immediately for tow groups patients were recorded.ResultsMAP、HR at pneumoperitoneum immediately,group A was lowest than groupB(P<0.01);Blood Glue at 20 min after pneumoperitoneum and postoperative immediately,group A was lower than group B(P<0.05).ConclusionPropofol combined with remifentanil total intravenous anaesthesia can more effective to prevent the effects of immune status from CO2 pneumoperitoneum than propofol combined with isoflure infusion-intravenous.
【Key words】
Laparoscopic operation; Remifentanil; Propofol; Total intravenous anaesthesia;Isoflurane infusion-intravenous anaesthesia
腹腔镜手术创伤小、术后恢复快,近年来已被各医院广泛应用,但由于二氧化碳气腹的实施易导致手术中的患者的应激反应较大,给麻醉造成一定风险。本研究对比观察丙泊酚和瑞芬太尼的全静脉麻醉与丙泊酚和异氟醚的静吸复合麻醉在择期腹腔镜手术中对二氧化碳气腹所致的应激反应。
1资料与方法
1.1病例选择与分组随机选取择期ASAI~II级拟行腹腔镜胆囊切除患者100例,男52例、女48例,年龄20~60岁,均无高血压、冠心病、糖尿病及其他内分泌代谢性疾病,均在腹腔镜下完成胆囊切除术。
1.2麻醉方法两组患者术前30 min均肌肉注射阿托品0 ......
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