CAJ | 학술논문

目的研究分析不同剂量瑞芬太尼辅助硬膜外麻醉在妇科腹腔镜手术中的应用效果以及安全性。方法以2011年3月至2012年4月在我院妇科进行的，硬膜外麻醉下行腹腔镜手术的患者110例为研究对象，使用计算机随机选择的方法将患者分为两组，I组患者给0.05μg/（kg?min），II组给予0.07μg/（kg?min），对比观察两组患者的镇痛起效时间、维持时间以及不良反应，在不同时间点对患者进行痛觉的视觉模拟评分。同时对两组患者的血压、脉搏、呼吸和血氧饱和度在麻醉前后进行观察。结果两组患者治疗前后的血压、脉搏以及呼吸比较无显著差异，P ＞0.05，差异无统计学意义；2组的痛觉视觉的模拟评分都低于2分，所以两组的镇痛效果差异没有统计学意义。II组患者不良反应明显高于I组患者，P ＜0.05，差异有统计学意义。结论使用微泵静脉注射小剂量的的瑞芬太尼同时辅助硬膜外麻醉的方法在效果上是可行的，小剂量的持续泵入维持麻醉，在妇科腹腔镜手术中不仅取得了良好的镇痛效果，而且可以减少不良反应的发生。
목적연구분석불동제량서분태니보조경막외마취재부과복강경수술중적응용효과이급안전성。방법이2011년3월지2012년4월재아원부과진행적，경막외마취하행복강경수술적환자110례위연구대상，사용계산궤수궤선택적방법장환자분위량조，I조환자급0.05μg/（kg?min），II조급여0.07μg/（kg?min），대비관찰량조환자적진통기효시간、유지시간이급불량반응，재불동시간점대환자진행통각적시각모의평분。동시대량조환자적혈압、맥박、호흡화혈양포화도재마취전후진행관찰。결과량조환자치료전후적혈압、맥박이급호흡비교무현저차이，P ＞0.05，차이무통계학의의；2조적통각시각적모의평분도저우2분，소이량조적진통효과차이몰유통계학의의。II조환자불량반응명현고우I조환자，P ＜0.05，차이유통계학의의。결론사용미빙정맥주사소제량적적서분태니동시보조경막외마취적방법재효과상시가행적，소제량적지속빙입유지마취，재부과복강경수술중불부취득료량호적진통효과，이차가이감소불량반응적발생。
Objective To research and analysis of different doses of remifentanil auxiliary application effect of epidural anesthesia in gynecological laparoscopic surgery, as well as security. Methods April-2012 March 2011 in our hospital gynecological, epidural anesthesia for laparoscopic surgery 110 patients for the study, the method of using a computer randomly selects the patients were divided into two groups, I group patients to 0.05μg/(kg? min), II group was given 0.07μg/(kg ? min) contrast observed in both groups of patients with analgesic onset time, maintenance time as well as adverse reactions, visual analogue scale of pain patients at different time points. The same time, the two groups of patients with blood pressure, pulse, respiration and blood oxygen saturation were observed before and after anesthesia. Results The two groups of patients before and after treatment, blood pressure, pulse, and respiration were no significant differences (P>0.05), the difference was not statistically significant;pain visual analogue scale of less than 2 points, so both groups analgesic effect of differences No statistically significant. Group II patients was significantly higher than the group I patients, P<0.05, significant difference. Conclusion The use of micro-pump intravenous injection of a small dose of remifentanil auxiliary epidural is feasible, in effect, a small dose continuous infusion to maintain anesthesia in gynecological laparoscopic surgery not only made good analgesic effect, and can reduce the occurrence of adverse reactions.