瑞芬太尼在腹腔镜手术患者硬膜外麻醉中辅助作用.docVIP

瑞芬太尼在腹腔镜手术患者硬膜外麻醉中辅助作用 　　（景德镇市第三人民医院 江西 333000） 　　摘 要 目的：探讨瑞芬太尼在腹腔镜手术患者硬膜外麻醉中的辅助作用。方法：选取98例ASAⅠ-Ⅱ级的腹腔镜手术患者，采用随机数字表法分为高剂量组49例，给予瑞芬太尼0.07 mg/（kg?min），低剂量组49例，给予瑞芬太尼0.05 mg/（kg?min），比较两组镇痛效果差异。结果：高剂量组和低剂量组患者药物起效时间、镇痛维持时间和疼痛评分比较差异无统计学意义（P0.05），全部患者手术期间收缩压（SBP）、心率（HR）较手术前明显降低（P0.05），高剂量组手术期间血氧饱和度明显低于低剂量组和手术前（P0.05），但高剂量组不良反应发生率明显高于低剂量组。结论：不同剂量瑞芬太尼在腹腔镜手术患者硬膜外麻醉中辅助作用相当，但低剂量血氧饱和度和不良反应均明显改善。 　　关键词 瑞芬太尼 腹腔镜手术 硬膜外麻醉 　　中图分类号：R614.42 文献标识码：B 文章编号：1006-1533（2014）17-0042-03 　　Assistant effect of remifentanil on the patients 　　with epidural anesthesia during laparoscopic operation* 　　WANG Guowen** 　　（The Third People’s Hospital of Jingdezhen City， Jingdezhen 333000 ， China） 　　ABSTRACT Objective： To investigate the assistant effect of remifentanil on patients with epidural anesthesia during laparoscopic operation. Methods： Ninety-eight cases of laparoscopic operation patients with ASA gradeⅠ-Ⅱwere randomly divided into two groups， in which 0.07 mg/ （kg?min） of remifentanil were given to the patients in high dose group （n=49） while 0.05 mg/ （kg?min） in low dose group （n=49） and analgesic effects were compared. Results： There were no significant differences between two groups in drug onset time， postoperative analgesia duration and pain score （P0.05）. Systolic blood pressure （SBP） and heart rate （HR） in all patients were significantly decreased during operation compared with pre-operation （P0.05）. Oxygen saturation in blood was significantly lower in the high dose group than in the low dose group and that of pre-operation （P0.05） while adverse reaction rate was significantly higher in the high dose group than in the low dose group. Conclusion： Assistant effects of different doses of remifentanil on the patients with epidural anesthesia are quite different during laparoscopic operation， however， the oxygen saturation in blood and the adverse drug reactions are more significantly improved when low dose of remifentanil is used. 　　KEY WORDS remifentanil； laparoscopic operation；