目的 评价依托咪酯乳剂复合舒芬太尼与传统的丙泊酚乳剂复合芬太尼对妇产科腹腔镜手术中血流动力学的影响,比较两组苏醒及拔管时间、苏醒质量.方法 100例妇产科腹腔镜手术择期患者,按入院时的单双号排序随机分为观察组和对照组各50例.观察组患者依托咪酯乳剂+舒芬太尼全麻诱导并静脉持续微泵依托咪酯乳剂麻醉维持,对照组患者丙泊酚乳剂+芬太尼全麻诱导并静脉持续微泵丙泊酚乳剂麻醉维持.监测并记录两组患者在插管前5 min(基础值,T0)、全麻诱导后2 min(T1)、插管后即刻(T2)、气腹后5 min(T3)、手术半小时(T4)、苏醒拔管时(T5)的平均动脉压(MAP)、心率(HR)、血氧饱和度(SPO2)、呼气末二氧化碳分压(PETCO2)的变化,并记录苏醒时间、拔管时间及术中知晓情况.结果 两组患者的平均动脉压(MAP)、心率(HR)在T0时无明显区别,但在T1、T2、T3时观察组明显低于对照组,差异有显著性(P＜0.05);观察组患者苏醒时间为(5.1±2.3)min、拔管时间为(8.1±2.4)min,对照组为(10.3±5.2)min、(12.8±2.3)min;观察组患者苏醒期躁动、恶心呕吐发生率明显低于对照组(P＜0.05).结论 依托咪酯乳剂复合舒芬太尼应用于妇产科腹腔镜手术对血流动力学影响较小,术后并发症少,麻醉效果更安全可靠.%Objective To evaluate and compare hemodynamic effects and recovery,extubation time and analepsia quality differences of etomidate emulsion combined with sufentanil in contrast to traditional anesthetics (propofol emulsion combined with fentanyl) on gynecology and obstetrics laparoscopic operation.Methods 100 cases of laparoscopic operation of gynecology and obstetrics in elective patients,according to the admission scheduling single were randomly divided into the observation group of etomidate emulsion + sufentanil anesthesia group,50 cases; and the control group propofol emulsion + fentanyl anesthesia group,50 cases.Observation group used etomidate emulsion + sufentanil induction of general anesthesia and intravenous anesthesia etomidate emulsion pump,control group used propofol emulsion + fentanyl anesthesia induction and continuous intravenous micro pump anesthesia maintained by propofol emulsion,monitoring and recording the two groups at 5 minutes before intubation (basic values,T0),2 minutes after induction of general anesthesia (T1),immediately after intubation (T2),at 5 minutes after operation (T3),half an hour(T4),the mean arterial pressure (MAP) at time of awake extubation (T5),heart rate (HR),oxygen saturation (SPO2),breath not partial pressure of carbon dioxide (PETCO2) and other changes,and recorded the time of awakening and extubation time and intraoperative awareness.Results Two cases of the MAP,HR in T0 had no obvious difference,but the T1,T2,T3 in observation group were significantly lower than those in contrd group,there were statistically significant differences (P＜0.05); recovery time of group E was (5.1 ± 2.3) minutes,extubation time was (8.1 ± 2.4) minutes and restlessness,nausea and vomiting occurring rate were significantly lower than those in [(10.3 ± 5.2) minutes,(12.8 ± 2.3) minutes (P＜0.05)].Conclusion The application of etomidate emulsion combined with sufentanil in laparoscopic operation of gynecology and obstetrics of hemodynamic has less impact and postoperative complications,providing much safer and more reliable anesthesia effects.
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