中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2011年
7期
871-873
,共3页
丙泊酚%雷米芬太尼%靶控输注%腹腔镜胆囊切除术
丙泊酚%雷米芬太尼%靶控輸註%腹腔鏡膽囊切除術
병박분%뢰미분태니%파공수주%복강경담낭절제술
Propofol%remifentanil%Target-controlled infusion%Laparoscopic cholecystectomy
目的 比较雷米芬太尼联合丙泊酚靶控输注静脉麻醉与静脉+吸入复合麻醉在老年患者腹腔镜胆囊切除手术中的血流动力学变化及不良反应.方法 选择老年择期腹腔镜胆囊切除术患者56例,ASAⅠ-Ⅱ级,随机分为雷米芬太尼联合丙泊酚靶控输注麻醉28例(观察组)和静脉+吸入异氟醚维持麻醉28例(对照组).分别于各时点记录患者的HR、SBP、DBP、PET CO2、初醒时间、拔管时间和拔管后10 min OAAS 评分及术后24 h的恶心、呕吐及嗜睡情况.结果 观察组SBP、DBP及HR变化小于对照组;初醒时间、拔管时间和拔管后10 min OAAS评分观察组均优于对照组(均P＜0.05).而且观察组术后发生恶心、呕吐的患者明显较对照组均减少(均P＜0.05).结论 老年患者腹腔镜胆囊切除手术中丙泊酚复合雷米芬太尼靶控输注麻醉比静吸复合全麻能够更好的抑制应激反应,较容易维持循环稳定,且术后恢复快,不良反应更少,是老年患者腹腔镜胆囊切除术的理想麻醉方法.
目的 比較雷米芬太尼聯閤丙泊酚靶控輸註靜脈痳醉與靜脈+吸入複閤痳醉在老年患者腹腔鏡膽囊切除手術中的血流動力學變化及不良反應.方法 選擇老年擇期腹腔鏡膽囊切除術患者56例,ASAⅠ-Ⅱ級,隨機分為雷米芬太尼聯閤丙泊酚靶控輸註痳醉28例(觀察組)和靜脈+吸入異氟醚維持痳醉28例(對照組).分彆于各時點記錄患者的HR、SBP、DBP、PET CO2、初醒時間、拔管時間和拔管後10 min OAAS 評分及術後24 h的噁心、嘔吐及嗜睡情況.結果 觀察組SBP、DBP及HR變化小于對照組;初醒時間、拔管時間和拔管後10 min OAAS評分觀察組均優于對照組(均P＜0.05).而且觀察組術後髮生噁心、嘔吐的患者明顯較對照組均減少(均P＜0.05).結論 老年患者腹腔鏡膽囊切除手術中丙泊酚複閤雷米芬太尼靶控輸註痳醉比靜吸複閤全痳能夠更好的抑製應激反應,較容易維持循環穩定,且術後恢複快,不良反應更少,是老年患者腹腔鏡膽囊切除術的理想痳醉方法.
목적 비교뢰미분태니연합병박분파공수주정맥마취여정맥+흡입복합마취재노년환자복강경담낭절제수술중적혈류동역학변화급불량반응.방법 선택노년택기복강경담낭절제술환자56례,ASAⅠ-Ⅱ급,수궤분위뢰미분태니연합병박분파공수주마취28례(관찰조)화정맥+흡입이불미유지마취28례(대조조).분별우각시점기록환자적HR、SBP、DBP、PET CO2、초성시간、발관시간화발관후10 min OAAS 평분급술후24 h적악심、구토급기수정황.결과 관찰조SBP、DBP급HR변화소우대조조;초성시간、발관시간화발관후10 min OAAS평분관찰조균우우대조조(균P＜0.05).이차관찰조술후발생악심、구토적환자명현교대조조균감소(균P＜0.05).결론 노년환자복강경담낭절제수술중병박분복합뢰미분태니파공수주마취비정흡복합전마능구경호적억제응격반응,교용역유지순배은정,차술후회복쾌,불량반응경소,시노년환자복강경담낭절제술적이상마취방법.
Objective To compare target-controlled infusion of propofol combined with remifentanil total intravenous anesthesia and intravenous combined with inhalation anesthesia in hemodynamic changes and side effects in elderly patients with laparoseopic cholecystectomy.Methods 56 ASA Ⅰ-Ⅱ patients aged ＞60 Y undergoing elective laparoscopie cholecystectomy were randomly divided into propofol-remifentanil target controlled infusion group (observation group)(n=28)and inhalation anesthesia group(using intravenous anesthesia was maintained with isoflurane inhalation)(n=28).HR,SBP,DBP,PETCO2,initial consciousness time,extubation time,side-effects were recorded at each time points.Results The change extent of HR and blood pressure in observation group was lower than inhalation anesthesia group.The initial recovery time,recovery time of spontaneous breathing and extubation time in the observation group Was better than anesthesia group(all P＜0.05).The side-effects in observation group were significantly lower than inhalation anesthesia group(all P＜0.05).Conclusion Laparoscopic cholecystectomy in elderly patients by target-controlled infusion of propofol combined with remifentanil total intravenous anesthesia could significantly inhibit the stress response,and effectively maintain the stability of hemodynamic,and rapid postoperative recovery,fewer adverse reactions.It Was an ideal anesthesia methods in elderly patients with laparoscopic cholecystectomy.
