CAJ | 학술논문

目的：比较不同剂量瑞芬太尼联合丙泊酚用于腹腔镜手术的麻醉效果。方法选取2010年6月至2013年6月间于我院接受诊断和治疗的腹腔镜手术患者96例，采用随机数字表法将所有患者随机分为 A 组、B 组和 C 组三组，每组32例。观察比较不同时刻 BIS 值以及血流动力学参数和不良反应发生率。结果 A、B、C 三组患者 T1~4时刻 BIS 值均明显小于 T0时刻（P ﹤0.05），C 组患者 T1~4时刻 HR、MAP 以及 BIS 值均明显小于 B 组（P ﹤0.05）。与 A 组比较，B、C 两组患者体动反应发生率明显降低，而呼吸抑制的发生率明显升高（ P ﹤0.05）；与B 组比较，C 组患者体动反应发生率明显降低，而心动过缓、呼吸抑制以及低氧血症的发生率明显升高（P ﹤0.05）。结论瑞芬太尼血浆靶控浓度为6 ng/ ml 时，联合丙泊酚用于腹腔镜手术的麻醉效果最佳，值得在临床中推广应用。
목적：비교불동제량서분태니연합병박분용우복강경수술적마취효과。방법선취2010년6월지2013년6월간우아원접수진단화치료적복강경수술환자96례，채용수궤수자표법장소유환자수궤분위 A 조、B 조화 C 조삼조，매조32례。관찰비교불동시각 BIS 치이급혈류동역학삼수화불량반응발생솔。결과 A、B、C 삼조환자 T1~4시각 BIS 치균명현소우 T0시각（P ﹤0.05），C 조환자 T1~4시각 HR、MAP 이급 BIS 치균명현소우 B 조（P ﹤0.05）。여 A 조비교，B、C 량조환자체동반응발생솔명현강저，이호흡억제적발생솔명현승고（ P ﹤0.05）；여B 조비교，C 조환자체동반응발생솔명현강저，이심동과완、호흡억제이급저양혈증적발생솔명현승고（P ﹤0.05）。결론서분태니혈장파공농도위6 ng/ ml 시，연합병박분용우복강경수술적마취효과최가，치득재림상중추엄응용。
Objective:To compare the anesthetic effect with different dosage of Remifentanil combined with Propofol on laparoscopic surgery. Methods:Ninty-six patients with laparoscopic surgery were selected and randomly divided into the Group A,Group B and Group C and each had 32 cases. The BIS and hemodynamic parameters of different time and the in-cidence of adverse reactions were observed and compared. Results:The BIS of T1 to T4 were obviously lower than that of T0(P ﹤ 0. 05). The HR,MAP and BIS of Group C were obviously lower than those of Group C(P ﹤ 0. 05). The inci-dence of Movement in response of Group B and Group C were obviously lower than that of Group A while the incidence of Respiratory depression of Group B and Group C were obviously higher than that of Group A(P ﹤ 0. 05). The incidence of movement in response of Group C were obviously lower than that of Group B while the incidence of respiratory depression of Group C were obviously higher than that of Group B(P ﹤ 0. 05). Conclusion:When the target concentration in plasma of Remifentanil is 6ng/ ml,it produces the best anesthetic effect on laparoscopic surgery compared with Propofol and deserved promotion.