【摘要】 目的:探讨靶控输注丙泊酚复合硬膜外阻滞降低腹腔镜胆囊切除应激反应的可行性。方法:选择60例拟行腹腔镜胆囊切除病人,随机分为2组。研究组30例,行靶控输注丙泊酚复合硬膜外阻滞麻醉,对照组30例,行瑞芬太尼丙泊酚全凭静脉麻醉。分别于术前、麻醉后、腹腔充气15min、处理胆囊床和术后5个时点观察血压、心率、皮质醇、血糖及术后苏醒过程。结果:麻醉后,2组病人皮质醇、血糖、血压、心率与术前基础值比较均有非常显著差异(P<0.01),研究组血糖和皮质醇水平均低于对照组(P<0.01)。2组拔管时间和呼之睁眼时间无显著差异(P>0.05),定向力恢复时间研究组为(14±s6)min,需要镇痛药9例(30%),均低于对照组(20±10)min,19例(63%),P<0.01。结论:靶控输注丙泊酚复合硬膜外阻滞能有效降低腹腔镜胆囊切除应激反应。更多还原

【Abstract】 AIM: To explore the possibility of utilizing propofol by target-con t rolled infusion (TCI) combined with epidural anesthesia in reduction of the stre ss reaction during larparoscopic gallbladderectomy. METHODS: Sixty patients sch eduled for larparoscopic gallbladderectomy were randomly divided into two groups with 30 patients in each group. Propofol through TCI with epidural anesthesia w as taken for patients in the study group, and propofol-remifentanil under intravenous a n esthesia was taken for patients in the control group. Blood pressure, heart rate , serum level of cortisol, blood glucose and postoperative awakening course were observed before operation, after anesthesia, (15 min) after abdominal inflati on, during management of cystic bed and by the end of operation. RESULTS: After anaesthesia, the differences of blood pressure, heart rate, serum level o f cort isol and blood glucose of the two groups showed obvious significant difference w ith the correlative preoperative basic values respectively (P<0.01). Blood g luco se and cortisol in the study group were lower than those in the control group ( P <0.01). There were no significant differences of drawing tube time and opening e yes time between the two groups (P>0.05).Directional strength renew time and t he number of patient needing analgesia in the study group were lower than those in the control group ((14±s 6) min,9(30 %)) vs (((20±10) min),19((6 3 %) )), P<0.0 1. CONCLUSION: Propofol by TCI combined with epidural anesthesia can reduce stress rea ction of larparoscopic gallbladderectomy.更多还原