七氟烷或丙泊酚复合瑞芬太尼全麻对腹腔镜手术患者麻醉苏醒期的影响

发布时间：2018-01-16 16:18

  本文关键词：七氟烷或丙泊酚复合瑞芬太尼全麻对腹腔镜手术患者麻醉苏醒期的影响　出处：《中华临床医师杂志(电子版)》2016年21期 　论文类型：期刊论文

  更多相关文章： 七氟烷 二异丙酚 芬太尼

【摘要】：目的观察比较七氟烷与丙泊酚复合瑞芬太尼对腹腔镜微创手术患者麻醉后恢复质量的影响,为临床制定更有效麻醉方案提供参考。方法选择本院78例气管插管全麻后行腹腔镜微创手术治疗的女性患者,随机数字表法予以分两组:C1组39例(七氟烷复合瑞芬太尼维持麻醉);C2组39例(丙泊酚复合瑞芬太尼维持麻醉)。记录且比较两组围手术期各时间点收缩压(SBP)、舒张压(DBP)、心率(HR),拔气管导管时呼吸频率、手术结束至拔气管导管时间、恶心呕吐评分、最大Ricker镇静躁动评分、疼痛数字评分(NRS)评分、咳嗽评分及恢复质量评分(Qo R-40评分)。结果两组患者的SBP、DBP、HR在各时间点上比较差异均无统计学意义(均P0.05);两组患者拔管时呼吸频率差异无统计学意义(P0.05);与C1组比较,C2组手术结束至拔管时间短[(5.60±2.20)min vs.(10.40±2.50)min,t=9.140,P=0.000],咳嗽评分、恶心呕吐评分、NRS评分均低(P0.05);C2组最大Ricker镇静躁动评分低于C1组,差异有统计学意义(P0.05);C2组Qo R-40评分明显低于C1组,差异有统计学意义(P0.05)。结论丙泊酚复合瑞芬太尼与七氟烷复合瑞芬太尼在腹腔镜微创手术中,均具有稳定的麻醉效果,丙泊酚较七氟烷麻醉后恢复质量高,具有临床推广应用的价值。
[Abstract]:Objective to observe the effect of sevoflurane and propofol combined with remifentanil on the recovery quality of patients undergoing laparoscopic minimally invasive surgery. Methods 78 female patients undergoing laparoscopic minimally invasive surgery after tracheal intubation were selected. They were randomly divided into two groups: group C 1 (n = 39) (sevoflurane combined with remifentanil); Group C2 (propofol combined with remifentanil for maintenance anesthesia. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HRR) were recorded and compared between the two groups at different time points during perioperative period. Respiratory rate of trachea catheter, time from operation to trachea catheter, nausea and vomiting score, maximum Ricker sedative restlessness score, pain number score and NRS score. Results there was no significant difference in SBPnDBPHR between the two groups at each time point (P 0.05). There was no significant difference in respiratory frequency between the two groups during extubation (P 0.05). The time from operation to extubation in C2 group is shorter than that in C1 group. [5. 60 卤2. 20 minutes vs.(10.40 卤2. 50 vs.(10.40 卤9. 140 vs.(10.40, score of cough, score of nausea and vomiting, and 5. 60 卤2. 20??? NRS scores were all low (P 0.05); The maximum Ricker sedative restlessness score of C2 group was lower than that of C1 group (P 0.05). The Qo R-40 score in C2 group was significantly lower than that in C1 group (P 0.05). Conclusion propofol combined with remifentanil and sevoflurane combined with remifentanil in laparoscopic minimally invasive surgery. Propofol has higher recovery quality than sevoflurane and has the value of clinical application.
【作者单位】： 香港大学深圳医院麻醉科;南方医科大学深圳医院麻醉科;深圳市第二人民医院麻醉科;南方医科大学深圳医院手术室;
【基金】：深圳市科创委项目(JCYJ20140414092023240)
【分类号】：R614
【正文快照】： 现代麻醉不但要让患者无痛、安全,也要让患者舒适、满意地恢复。腹部微创手术创伤小、恢复快,有些患者当日即可下床活动,绝大多数患者第二天即到处行走,并进流质饮食,因此患者和家属对手术和麻醉后恢复的舒适度要求较高,目前麻醉医师对微创手术后患者舒适性的关注尚少。手术结，

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