中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
1期
96-99
,共4页
路耀军%韩潮%耿桂启%黄绍强
路耀軍%韓潮%耿桂啟%黃紹彊
로요군%한조%경계계%황소강
子宫肌瘤%丙泊酚%瑞芬太尼%靶控输注%腹腔镜
子宮肌瘤%丙泊酚%瑞芬太尼%靶控輸註%腹腔鏡
자궁기류%병박분%서분태니%파공수주%복강경
Uterine myoma%Propofol%Remifentanil%Target controlled infusion%Gynecological laparoscopic myomectomy
目的 探讨丙泊酚复合瑞芬太尼靶控输注在妇科腹腔镜子宫肌瘤剥除术中的麻醉效果与可行性.方法 选择2010年6月至2011年6月在我院择期行妇科腹腔镜子宫肌瘤剥除术的患者50例,美国麻醉医师学会分级Ⅰ、Ⅱ级,按随机数字表法随机分为两组:丙泊酚复合瑞芬太尼组25例和七氟醚复合瑞芬太尼组25例.麻醉诱导用药及方法相同.分别记录麻醉诱导前、气腹后30 min、术毕和拔出气管导管后3 min时的动脉收缩压、舒张压和心率,记录苏醒时间及拔管时间.结果 丙泊酚组患者围术期血压平稳,各个时点的收缩压、舒张压、心率与基础值相比差异均无统计学意义(P均＞0.05),七氟醚组患者收缩压、舒张压、心率在气腹后30 min及拔出气管导管后3 min时明显高于基础值和丙泊酚组患者,差异均有统计学意义(P均＜0.05).七氟醚组患者苏醒时间、拔管时间比丙泊酚组患者长,差异有统计学意义[(9.3±1.5)、(4.9±1.l)min,t=10.56,P=0.02;(12.9±2.4)、(6.8±1.2)min,t=12.36,P=0.01].结论 妇科腹腔镜子宫肌瘤剥除术采用丙泊酚复合瑞芬太尼靶控输注静脉麻醉安全可行,患者麻醉诱导平稳,术中血流动力学稳定,苏醒迅速完全,并发症少,值得临床推广.
目的 探討丙泊酚複閤瑞芬太尼靶控輸註在婦科腹腔鏡子宮肌瘤剝除術中的痳醉效果與可行性.方法 選擇2010年6月至2011年6月在我院擇期行婦科腹腔鏡子宮肌瘤剝除術的患者50例,美國痳醉醫師學會分級Ⅰ、Ⅱ級,按隨機數字錶法隨機分為兩組:丙泊酚複閤瑞芬太尼組25例和七氟醚複閤瑞芬太尼組25例.痳醉誘導用藥及方法相同.分彆記錄痳醉誘導前、氣腹後30 min、術畢和拔齣氣管導管後3 min時的動脈收縮壓、舒張壓和心率,記錄囌醒時間及拔管時間.結果 丙泊酚組患者圍術期血壓平穩,各箇時點的收縮壓、舒張壓、心率與基礎值相比差異均無統計學意義(P均＞0.05),七氟醚組患者收縮壓、舒張壓、心率在氣腹後30 min及拔齣氣管導管後3 min時明顯高于基礎值和丙泊酚組患者,差異均有統計學意義(P均＜0.05).七氟醚組患者囌醒時間、拔管時間比丙泊酚組患者長,差異有統計學意義[(9.3±1.5)、(4.9±1.l)min,t=10.56,P=0.02;(12.9±2.4)、(6.8±1.2)min,t=12.36,P=0.01].結論 婦科腹腔鏡子宮肌瘤剝除術採用丙泊酚複閤瑞芬太尼靶控輸註靜脈痳醉安全可行,患者痳醉誘導平穩,術中血流動力學穩定,囌醒迅速完全,併髮癥少,值得臨床推廣.
목적 탐토병박분복합서분태니파공수주재부과복강경자궁기류박제술중적마취효과여가행성.방법 선택2010년6월지2011년6월재아원택기행부과복강경자궁기류박제술적환자50례,미국마취의사학회분급Ⅰ、Ⅱ급,안수궤수자표법수궤분위량조:병박분복합서분태니조25례화칠불미복합서분태니조25례.마취유도용약급방법상동.분별기록마취유도전、기복후30 min、술필화발출기관도관후3 min시적동맥수축압、서장압화심솔,기록소성시간급발관시간.결과 병박분조환자위술기혈압평은,각개시점적수축압、서장압、심솔여기출치상비차이균무통계학의의(P균＞0.05),칠불미조환자수축압、서장압、심솔재기복후30 min급발출기관도관후3 min시명현고우기출치화병박분조환자,차이균유통계학의의(P균＜0.05).칠불미조환자소성시간、발관시간비병박분조환자장,차이유통계학의의[(9.3±1.5)、(4.9±1.l)min,t=10.56,P=0.02;(12.9±2.4)、(6.8±1.2)min,t=12.36,P=0.01].결론 부과복강경자궁기류박제술채용병박분복합서분태니파공수주정맥마취안전가행,환자마취유도평은,술중혈류동역학은정,소성신속완전,병발증소,치득림상추엄.
Objective To investigate the anaesthetic effect of propofol combined with remifentanil by target-controlled infusion (TCI) used in gynecological laparoscopic myomectomy.Methods Fifty cases,who were scheduled for gynecological laparoscopic myomectomy in our hospital from June 2010 to June 2011,was randomly divided into propofol combined with remifentanil group (n =25) and inhalation anesthesia (remifentanil combined with sevoflurane) group (n =25).The heart rate and blood pressure were recorded at the time of before induction of anesthesia (T0),30 min after carbon dioxide pneumoperitoneum,the end of operation and 3 min after extubation.The awake time,time of extubation and surgery time were also recorded.Results The hemodynamics were kept stable in propofol combined with remifentanil group,and there were no significant difference with respect to SABP,DABP and heart rate at all time points compared with baseline (P ＞0.05) in propofol group.However,in inhalation anesthesia group,SABP,DABP and heart rate were increased significantly at 30 min after carbon dioxide pneumoperitoneum and 3 min after extubation when compared with baseline (P ＜ 0.05) and were higher than those of propofol group (P ＜ 0.05) at counterpart time points.In inhalation anesthesia group,the awake time ((9.3 ± 1.5) min vs (4.9 ± 1.1) min,t =10.56,P =0.017) and time of extubation ((12.9 ± 2.4) min vs.(6.8 ± 1.2) min,t =12.36,P =0.01) were significantlv longer than that of propofol group (P ＜ 0.05).Conclusion Propofol combined with remifentanil TCI-based anesthesia could achieve the optimal hemdynamic stability during anesthesia maintance and better recovery profile from anesthesia in gynecological laparoscopic myomectomy.
