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目的观察靶控输注丙泊酚复合瑞芬太尼全凭静脉麻醉用于腹腔镜子宫切除术的有效性和安全性。方法将60例ASAⅠ～Ⅱ级拟行择期腹腔镜子宫切除术的患者随机分为2组,每组30例。Ⅰ组为芬太尼、丙泊酚、安氟醚静吸复合麻醉组,Ⅱ组为瑞芬太尼、丙泊酚全凭静脉麻醉组。观察2组患者入室后(T1)、诱导后(T2)、插管后(T3)、充气后30s(T4)、术毕(T5)各时点血压、心率变化及麻醉恢复情况(睁眼、拔除气管导管时间)。结果Ⅱ组患者T2、T3、T4时的MAP均低于Ⅰ组(P均<0.05),Ⅱ组患者T2时的心率低于Ⅰ组(P<0.05),T5时心率高于Ⅰ组(P<0.05),其余各时间点的心率、血压2组间比较,差异无统计学意义(P均>0.05)。Ⅱ组患者术后清醒及拔管时间均短于Ⅰ组(P<0.05)。结论靶控输注丙泊酚复合瑞芬太尼静脉麻醉可安全有效地用于腹腔镜子宫切除术,可抑制插管时的应激反应,术中患者生命体征平稳,术后苏醒迅速,且缩短患者手术室停留时间。
Objective To observe the effectiveness and safety of target controlled infusion of propofol combined with remifentanil in total laparoscopic hysterectomy. Methods Sixty ASA Ⅰ ~ Ⅱ patients undergoing elective laparoscopic hysterectomy were randomly divided into two groups (n = 30 in each group). Group Ⅰ was fentanyl, propofol, enflurane combined inhalation anesthesia group, group Ⅱ was remifentanil, propofol total intravenous anesthesia group. The changes of blood pressure, heart rate and recovery of anesthesia were observed at T1, T2, T3, 30s (T4) and T5 after operation (eyes open, Remove the tracheal tube time). Results The MAP of T2, T3 and T4 in group Ⅱ was lower than that in group Ⅰ (all P <0.05). The heart rate of group Ⅱ was lower than that of group Ⅰ (P <0.05) <0.05). There was no significant difference in heart rate and blood pressure between the two groups at any time point (P> 0.05). The duration of awake and extubation in group Ⅱ was shorter than that in group Ⅰ (P <0.05). Conclusion Target-controlled infusion of propofol combined with remifentanil can effectively and safely be used for laparoscopic hysterectomy and can inhibit the stress response during intubation. The vital signs of patients during operation are stable and the postoperative recovery is rapid. Shorten the patient’s operating room stay time.