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瑞芬太尼复合异丙酚全静脉麻醉用于腹腔镜胆囊切除手术的临床研究 被引量:3

Combined intravenous anesthesia with remifentanil and propofol during laparoscopic cholecystectomy
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摘要 目的 评价瑞芬太尼复合异丙酚全静脉麻醉用于腹腔镜胆囊切除手术时对血流动力学、术后恢复时间及脑动-静脉血氧含量差的影响。方法 ASAⅠ -Ⅱ级 ,择期行腹腔镜胆囊切除手术的患者 30例 ,随机分成静脉全麻组 (R组 )和静吸复合麻醉组 (I组 ) ,于手术各时点分别检测血流动力学指标 ,并测定动静脉血气 ,计算脑动 -静脉血氧含量差 ,并比较术后恢复时间。结果 气管插管后I组血流动力学变化比R组大 (P <0 .0 5 ) ,R组术后恢复时间明显低于I组 (P <0 .0 5 ) ,气腹后R组脑动 -静脉血氧含量明显低于I组 (P <0 .0 5 ) ,两组术后VAS评分没有明显差别 (P >0 .0 5 )。结论 瑞芬太尼复合异丙酚全静脉麻醉降低血流动力学变化 ,降低脑动 -静脉血氧含量的升高 ,可能有利于腹腔镜胆囊切除手术时脑的保护。 Objective To investigate the effects of remifentanil and propofol on hemodynamics, extubation and awakening times, and arterial-jugular venous oxygen content difference(Ca-jvDO 2) during laparoscopic cholecystectomy.Methods Thirty ASAⅠ-Ⅱ patients undergoing elective laparoscopic cholecystectomy were enrolled and randomly allocated to receive total intravenous anesthesia(R group,n=16,propofol and remifentanil) or inhalation plus intravenous anesthesia(I group,n=14, midazolam,propofol and fentanyl),and the data of hemodynamics, extubation and awakening times, and arterial-jugular venous oxygen content difference(Ca-jvDO 2) were compared between the two groups.Results Data of hemodynamics in I group were significantly higher than those in R group(P<0.05); the latter showed shorter extubation and awakening times(P<0.05), and less changes in Ca-jvDO 2 than those in I group(P<0.05).The VAS did not differ in the two groups(P>0.05).Conclusions Combinational infusions of remifentanil and propofol during laparoscopic cholecystectomy decrease hemodynamics imbalance and Ca-jvDO 2,it is indicated to be the effect protection of cerebral tissue.
作者 黄安宁 陈娜
出处 《武警医学》 CAS 2005年第2期105-108,共4页 Medical Journal of the Chinese People's Armed Police Force
关键词 腹腔镜胆囊切除手术 静脉血 复合异丙酚 全静脉麻醉 瑞芬太尼 血氧含量 血流动力学 结论 变化 时间 Remifentanil Propofol Laparoscopic cholecystectomy Cerebral arterial-jugular venous oxygen content
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