摘要
目的观察依托咪酯复合瑞芬太尼对腹腔镜手术麻醉效果及血流动力学的影响。方法选取2016年1月至2016年5月于山西医科大学第二医院妇科行腹腔镜手术患者160例,按照随机数字表法分为观察组和对照组,每组80例,观察组予以依托咪酯+瑞芬太尼麻醉,对照组予以丙泊酚+瑞芬太尼麻醉,观察并记录两组患者麻醉效果、苏醒时间、拔管时间、止痛时间以及气管插管时、腹腔镜置入时患者收缩压(SBP)、舒张压(DBP)、心率(HR)等相关血流动力学指标的变化。结果观察组麻醉效果优良率为98.0%,明显高于对照组的86.0%(χ2=4.444,P<0.05);苏醒时间、拔管时间、止痛时间均短于对照组,均差异无统计学意义(t=1.875、1.631、1.761,均P>0.05);两组患者气管插管时SBP、DBP、HR等指标均差异无统计学意义(t=1.301、1.093、1.097,均P>0.05);麻醉诱导后,气管插管时依托咪酯组患者SBP、DBP均明显高于对照组(t=6.182、7.388,均P<0.05),心率差异无统计学意义(t=1.428,P>0.05);腹腔镜置入时观察组SBP、DBP均明显高于对照组(t=5.781、5.028,均P<0.05);腹腔镜置入后观察组患者SBP、DBP与对照组均差异无统计学意义(t=1.601、1.206,均P>0.05),气管拔管后观察组SBP与对照组差异无统计学意义(t=1.203、1.039,均P>0.05)。结论依托咪酯复合瑞芬太尼对妇科腹腔镜手术麻醉效果明显优于丙泊酚联合瑞芬太尼,麻醉期间SBP、DBP、HR等血流动力学指标更稳定。
Objective To observe the anesthesia and hemodynamic effect of etomidate compound remifentanyl in laparoscopic surgery.Methods From January 2016 to May 2016,160 patients with gynecologic laparoscopic surgery in the Second Hospital of Shanxi Medical University were selected and randomly divided into observation group and control group according to the digital table,with 80 cases in each group.The observation group received the etomidate compound remifentanyl anesthesia,while the control group received the propofol compound remifentanyl anesthesia.the The anesthesia effect,awakening time,extubation time,pain relief time and systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)before and after extubation of the two groups were observed and recorded.Results The excellent and good rate in the observation group was 98.0%,which was significantly higher than 86.0%in the control group(χ2=4.444,P<0.05).The waking time,extubation time,analgesic time in the observation group were shorter than those in the control group,the differences were no statistically significant(t=1.875,1.631,1.761,all P>0.05).At tracheal intubation,the SBP,DBP,HR and other indicators between the two groups had no statistically significant differences(t=1.301,1.093,1.097,all P>0.05).After induction of anesthesia,the SBP,DBP in the observation group were higher than those in the control group,the differences were statistically significant(t=6.182,7.388,all P<0.05),but HR between the two groups had no statistically significant difference(t=1.428,P>0.05).After laparoscopic placement and tracheal extubation,the SBP and DBP in the observation group were significantly higher than those in the control group,the differences were statistically significant(t=5.781,5.028,all P<0.05),and the SBP in the observation group was higher than that in the control group after tracheal extubation(t=1.203,1.039,all P<0.05).Conclusion The anesthesia effect of etomidate compound remifentanyl is superior to propofol compound remifentanyl,the hemodynamic parameters of SBP,DBP,HR are more stable during the period of anesthesia,the curative effect is clear.
作者
贾丽玲
杨建新
李雁楠
杨光
张丽慧
Jia Liling;Yang Jianxin;Li Yannan;Yang Guang;Zhang Lihui(Department of Anesthesiology,the Second Hospital of Shanxi Medical University,Taiyuan,Shanxi 030001,China)
出处
《中国基层医药》
CAS
2020年第1期59-63,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
麻醉
静脉
妇科外科手术
腹腔镜手术
麻醉效果
依托咪酯
瑞芬太尼
二异丙酚
血流动力学
Anesthesia,intravenous
Gynecologic surgical procedures
Laparoscopic surgery
Anesthetic effect
Etomidate
Remifentanyl
Propofol
Hemodynamics
