丙泊酚及七氟醚复合瑞芬太尼麻醉对腹腔镜胆囊切除术患者应激反应及血流动力学的影响

发布时间：2018-07-04 19:25

本文选题：丙泊酚 + 七氟醚　；参考：《中国乡村医药》2013年18期

【摘要】：目的对比研究丙泊酚与七氟醚复合瑞芬太尼麻醉对腹腔镜胆囊切除术患者应激反应和血流动力学的影响。方法选取80例拟行腹腔镜胆囊切除术的患者,分为PR组(丙泊酚+瑞芬太尼)和SR组(七氟醚+瑞芬太尼),每组各40例。两组采取相同的麻醉诱导方法,麻醉维持:PR组采用丙泊酚4~8mg/(kg·h)静脉输注,SR组采用七氟醚2%~3%复合吸入,两组均予瑞芬太尼2~4μg/(kg·h)。观察两组患者麻醉诱导前(T0)及插管后5min(T1)的应激反应及血流动力学指标的变化情况。结果 T1时,PR组与SR组的血糖水平与T0相比无明显差异,而两组的皮质醇水平均低于T0;SR组皮质醇水平在T1时较PR组低。PR组在T1时的HR、DBP、SBP均较T0时有所下降,而SR组却无明显变化;SR组的上述指标在T1时高于PR组。两组SpO2水平在麻醉前后均无明显变化。结论七氟醚复合瑞芬太尼用于腹腔镜胆囊切除术麻醉诱导时,对血流动力学影响较小,并且可以更好地抑制麻醉过程引起的应激反应,为手术过程提供一个更加平稳的麻醉维持。
[Abstract]:Objective to compare the effects of propofol and sevoflurane combined with Reventa Ni anesthesia on stress response and hemodynamics in patients with laparoscopic cholecystectomy. Methods 80 cases of laparoscopic cholecystectomy were selected to be divided into group PR (propofol + Reventa Ni) and group SR (sevoflurane + Reventa Ni), 40 cases in each group. The two groups were the same. Anesthesia induction method, anesthesia maintenance: PR group was injected with propofol 4~8mg/ (kg. H) intravenous infusion, SR group used sevoflurane 2%~3% combined inhalation, the two groups were given remifentanil 2~4 mu g/ (kg h). The changes of stress response and hemodynamic indexes of the two groups were observed before anesthesia induction (T0) and after intubation. There was no significant difference in sugar level compared with T0, but the level of cortisol in the two groups was lower than that of T0, and the level of cortisol in group SR was lower than that of PR in group PR, DBP and SBP in.PR group at T1, but there was no obvious change in SR group. The above indexes were higher than that of the group. The two groups had no obvious changes before and after anesthesia. Conclusion sevoflurane was found. The effect of compound remifentanil on the anesthesia induction of laparoscopic cholecystectomy has less influence on hemodynamics, and it can better inhibit the stress response caused by the anesthesia process and provide a more stable anesthesia maintenance for the operation process.
【作者单位】：浙江东阳市红十字会医院麻醉科;
【分类号】：R614

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