异丙酚复合瑞芬太尼在高血压患者腹腔镜手术麻醉中的应用效果分析.doc

精品论文 参考文献 异丙酚复合瑞芬太尼在高血压患者腹腔镜手术麻醉中的应用效果分析 何富强 　　成都第四人民医院 四川成都 610000 　　【摘 要】目的：分析异丙酚复合瑞芬太尼在高血压患者腹腔镜手术麻醉中的应用效果。方法：将我院收治的64例行腹腔镜手术治疗的高血压患者随机分为观察组32例和对照组32例。2组患者均行相同的麻醉诱导方案，在麻醉维持上，观察组患者行异丙酚复合瑞芬太尼麻醉，对照组患者行单纯的异丙酚麻醉。记麻醉诱导前即刻为T0，气管插管后即刻为T1，CO2气腹建立前为T2，CO2气腹建立后10min为T3，拔管即刻为T4，监测并统计各时刻点上2组患者的心率（HR）及平均动脉压（MAP）。同时，统计2组患者整个手术过程中硝酸甘油和艾司洛尔的使用剂量，记录拔管时间，并采用Steward 苏醒评分标准评价患者的苏醒质量。结果：观察组患者T1～T4时刻的HR、MAP指标值较T0时刻均无明显波动（P﹥0.05）；对照组患者T1时刻的HR、MAP指标值较T0时刻均上升（P＜0.05），且T3时刻的HR、MAP指标值较T2时刻均上升（P＜0.05）。观察组患者的平均拔管时间短于对照组（P＜0.05），平均硝酸甘油用量、艾司洛尔使用量均少于对照组（P＜0.05），且Steward 苏醒评分高于对照组（P＜0.05）。结论：在高血压患者腹腔镜手术麻醉中的应用异丙酚复合瑞芬太尼麻醉能有效提高麻醉质量，促进患者血流动力学的稳定，并明显减少患者辅助药物的使用量，提高苏醒质量。 　　【关键词】腹腔镜手术；高血压；麻醉；异丙酚；瑞芬太尼 　　【中图分类号】R614 【文献标识码】B 【文章编号】1674-8999（2015）8-0237-02 　　Analysis of Propofol composite remifentanil in patients with high blood pressure, the application of laparoscopic surgery anesthesia effect 　　【Abstract】objective: to analyze Propofol composite remifentanil in patients with high blood pressure, the application of laparoscopic surgery anesthesia effect. Methods: our hospitalrsquo;s 64 cases of hypertension patients who treated by laparoscopic surgery were randomly divided into the observation group (32 cases) and the control group (32 cases). 2 groups of patients were anaesthetized by the same anesthesia induction of anesthesia, maintain in anesthesia, observation group patients were anaesthetized by Propofol composite remifentanil,the control group patients were anaesthetized by the simple propofol anesthesia. Immediately before anesthesia induction was recorded as T0, Immediately after endotracheal intubation was T1, before CO2 pneumoperitoneum to establish was T2, CO2 pneumoperitoneum is set up 10 min after was T3, tube drawing immediate was T4, 2 groups of patients in each time point of heart rate (HR) and mean arterial pressure (MAP) were detected. The whole operation process at the same time, 2 groups of patients in the use of nitroglycerin and YiSiLuo dose was statistics, extubation time