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腹腔镜胆囊切除术静吸复合快通道麻醉临床观察
Clinical Observation of fast-tracking inhalation intravenous combined anesthesia in laparoscopic cholecystectomy
【摘要】 目的:研究全凭静脉与快通道静吸复合全麻用于腹腔镜胆囊切除术(Laparoscopic cholecystectomy,LC)的临床效果。方法:选择ASAⅠ-Ⅱ级LC病人60例,随机分两组各30例,全凭静脉组(A组);快通道静吸复合组(B组)。术前和诱导用药相同,维持A组静脉输注异丙酚,间断追加芬太尼、维库溴铵。B组吸入异氟醚,不追加维库溴铵。观察平均动脉压(MAP),心率(HR),呼气末二氧化碳分压(PETCO2),血气分析,麻醉药用量,拔管时间及围术期不良反应。结果:两组MAP、HR、PETCO2、血气分析、不良反应等比较差异无显著性(P>0.05)。异丙酚(290±51与128±38)mg、维库溴铵(11.6±2.1与7.3±2.0)mg、芬太尼(0.44±0.04与0.31±0.2)mg用量、拔管时间(96±9与76±10)min,两组间差异都非常显著(P<0.01)。结论:快通道静吸复合全麻用于LC方便快捷、术中平稳、术后苏醒快、拔管早、安全效果好。
【Abstract】 Objective:To investigate the clinical effect of fast-tracking inhalation intravenous combined anesthesia undergoing laparoscopic cholecystectomy and compare it with total intravenous anesthesia. Methods:60 ASA Ⅰ-Ⅱpatients undergoing laparoscopic cholecystectomy were randomly divided into two groups,with 30 cases in each group. Group A received total intravenous anesthesia;Group B received fast-tracking inhalation intravenous combined anesthesia. All patients were induced with the same medicine,Anesthesia was maintained with propofol、remifentanil and atracurium in group A and maintained with enflurane in group B.MAP,HR,PETCO2 and Consciousness recovery time,tracheal intubatton to extubation time and adverse reaction bypass surgery were observed.Results:The two groups showed non-significant differences in MAP、HR、PETCO2、blood gas analysis and adverse reaction (P>0.05),The two groups showed significant differences in the dosage of propofol(290±51 to 128±38mg)、atracurium(11.6±2.1 to 7.3±2.0mg)、remifentanil(0.44±0.04 to 0.31±0.2mg)and tracheal extubation time(P<0.01). Conclusion:Fast-tracking Inhalation intravenous combined anesthesia in laparoscopic cholecystectomy was quick and convenient,stable in surgery safe and effective,and could get a rapid recovery and pull out tube early.
【Key words】 Cholecystectomy; Laparoscopic; Inhalation intravenous combined anesthesia; Fast-tracking anesthesia;
- 【文献出处】 现代医药卫生 ,Modern Medicine & Health , 编辑部邮箱 ,2007年19期
- 【分类号】R614
- 【下载频次】33