右美托咪定复合瑞芬太尼在腹腔镜胆囊切除术中的应用

目的：观察右美托咪定复合瑞芬太尼在腹腔镜胆囊切除术( LC)中的临床效果。方法回顾性分析2014年1月—2015年6月行LC患者120例,分为观察组60例给予右美托咪定复合瑞芬太尼麻醉；对照组60例给予丙泊酚复合瑞芬太尼麻醉。比较两组插管前(T0)、插管即刻(T1)、气腹后20 min(T2)、拔管后5 min(T3)的平均动脉压( MAP)和心率( HR),并观察停药后自主呼吸时间、睁眼时间、拔管时间及手术后视觉疼痛模拟评分( VAS)、不良反应发生情况。结果两组自主呼吸时间、睁眼时间、拔管时间比较差异无统计学意义( P>0．05)。观察组MAP在T1和T2时低于对照组(P<0．05),HR在T1、T2和T3时低于对照组(P<0．05)。观察组术后4和24 h的VAS评分和不良反应发生率均低于对照组(P<0．05)。结论右美托咪定复合瑞芬太尼在LC术中麻醉效果优于丙泊酚复合瑞芬太尼。

Dexmedetomidine Combined with Remifentanil in Application of Laparoscopic Cholecystectomy

Objective To observe effect of Dexmedetomidine combined with Remifentanil in application of lapa-roscopic cholecystectomy ( LC) . Methods Clinical data of 120 patients undergoing LC during January 2014 and June 2015 was retrospectively analyzed, and the patients were divided into observation group (n=60) and control group (n=60). Observation group was treated with anesthesia by Dexmedetomidine combined with Remifentanil, while control group received anesthesia by Propofol combined with Remifentanil. In two groups, levels of mean arterial blood pressure (MAP) and heart rate (HR) before intubation (T0), at the time of intubation (T1), 20 mins after pneumoperitoneum (T2) and 5 mins after extubation were observed, and spontaneous breathing time, opening eyes time and extubation time, and postoperative visual analogue scales (VAS) score and complications in two groups were also observed. Results There were no significant differences in spontaneous breathing time, opening eyes time and extubation time in two groups ( P>0. 05 ) . Compared with those in control group, in observation group, MAP levels at T1 and T2 were de-creased (P<0. 05), HR levels at T1, T2 and T3 were decreased (P<0. 05). In observation group, values of VAS scores and incidence rate of adverse reaction postoperative 4 and 24 h were lower than those in control group (P<0. 05). Conclusion Dexmedetomidine combined with Remifentanil in application of laparoscopic cholecystectomy can achieve better anesthesia effect than that by Propofol combined with Remifentanil.