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1. 重庆医科大学附属第一医院麻醉科
2. 重庆医科大学附属第一医院麻醉科,重庆,400016
纸质出版日期:2007,
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[1]李琪英,闵苏.异丙酚复合芬太尼或瑞芬太尼静吸复合麻醉在妇科腹腔镜手术的比较[J].重庆医科大学学报,2007(12):1329-1331.
LI Qiying, et al. Comparison remifentanil and fentanyl in combined anesthesia of gynaecologic laparoscopy[J]. Journal of Chongqing Medical University, 2007,(12):1329-1331.
[1]李琪英,闵苏.异丙酚复合芬太尼或瑞芬太尼静吸复合麻醉在妇科腹腔镜手术的比较[J].重庆医科大学学报,2007(12):1329-1331. DOI: 10.13406/j.cnki.cyxb.2007.12.012.
LI Qiying, et al. Comparison remifentanil and fentanyl in combined anesthesia of gynaecologic laparoscopy[J]. Journal of Chongqing Medical University, 2007,(12):1329-1331. DOI: 10.13406/j.cnki.cyxb.2007.12.012.
目的:评价异丙酚和瑞芬太尼静脉麻醉的诱导和术后苏醒过程。方法:ASAⅠ—Ⅱ级择期行腹腔镜卵巢肿廇和输卵管切除手术的病人90例
年龄16~42岁
随机分为异丙酚瑞芬太尼(R)组及异丙酚芬太尼(F)组
每组45例。观察麻醉诱导及气管插管时的血压、心率;记录术毕停药后病人自主呼吸恢复时间、呼之睁眼时间、拔管时间、定向力恢复时间和离开恢复室时间;观察病人拔管后即刻、离开恢复室、拔管后1、3和24h的意识状态(OAAS)
认知功能测试(MMSE)
疼痛评分(VRS);观察恶心呕吐等副反应
记录术中知晓的发生率和病人满意度等。结果:两组病人诱导血压均下降
无显著差异
F组的插管反应发生率高于R组
术中血流动力学稳定。两组病人术后自主呼吸恢复时间、呼之睁眼时间、拔管时间有显著性差异。R组病人在拔管后即刻、离开PACU时间、拔管后1h的VRS评分高于F组。病人术后的恶心呕吐发生率差异无显著性。结论:腹腔镜卵巢肿瘤和输卵管切除术时异丙酚瑞芬太尼静脉麻醉苏醒质量上更优于异丙酚芬太尼静脉
瑞芬太尼麻醉组病人术后很快就会感到疼痛
术后镇痛应及时开始。
Objective:The purpose of this study is to evaluate the clinical efficacy of remifentanil combined with proopofol in the course of anesthesia induction and analepsia. Methods: 90 ASAⅠ~Ⅱpatients excision of tumor of the ovary and salphingectomy undergoing gynaecologic laparoscopy were randomly divided into two groups:R group (propofol and vemifentanil n=45) and F group (propofol and fentanil n=45).MAP and HR were observed at the time of anesthesia induction tracheal intubation;the time of spontaneuusly breathing
awakeness
extubation
orientation force and the time of PACU were record;we view the patient of conscious state
cognition functional and the degree of pain;and observe the side effects of nausea and vomitting
intraoperative awareness and degree of patients’satisfaction. Result:There was no significant diference in decrease of two group of MAP in the course of anesthesia. The rate of cardiovascular response to tracheal intubation in F group is higher than that in R group
and hemobynamics was stabler. There was significantly diference in the time of spontaneously breathing
awakeness and extubation. At the time instant extubation and departing PACU were shorter
VAS after extubation 1h in R group was higher than that in F group. There was no significant diference in incidence rate of postoperative nausea and vomitting. Conclusion: Awake qualily of intravenous anesthesia with Propofol and remifentanil was better than that with Propofol and fentanil in excision of tumor of the ovary and salpingectomy undergoing gynaecologic laparoscopy. As half life of remifentanil was short
patients felt pain soon after operation and pestoperative analgesia should be performed promptly.
异丙酚瑞芬太尼静脉麻醉吸入嘛醉
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