摘要
Abstract
Objective To explore the effects of target controlled infusion ( TCI) of propofol combined with remifentanil on the stress reaction of patients underwent laparoscopic cholecystectomy. Methods Totally 90 patients underwent laparoscopic cholecystectomy were divided into group A,B,C. TCI of 3 μg/mL propofol and 3 ng/mL remifentanil was applied in group A, TCI of 3 μg/mL propofol in group B and 0.2 ~ 0. 6 mg · kg-1 · h-1 propofol through the venous pump in group C. The heart rate ( HR) , mean arterial pressure ( MAP) , arterial oxygen saturation (SpO2 ) , end-tidal pressure of carbon dioxide (PETCO2) , and the levels of corticosteroid (COR) , interleukin-6 (IL-6) , C-reaction protein (CRP) , blood glucose (GLU) were analyzed and compared at different time points of before the anesthesia (TO) , after the induction ( Tl) , 30 minutes after the pneumoperitoneum (T2) , operation finished ( T3 ) and 24 hours after the operation ( T4 ) . Results There was no significant difference in HR, MAP, SpO2 , PETCO2 during the anesthesia between group A and B(P >0. 05). The HR in group C was increased but MAP was decreased after the anesthesia. SpO2was obviously lowered at Tl and T2 compared with that at TO in group C and the PETC02was increased at Tl ~ T4 compared with that at TO (P<0. 05). There were obvious differences in HR and MAP at Tl ~T4 between group A and group C (P<0.05). SpO2was obviously higher at Tl and T2 and PETCO2was lower at Tl ~ T3 between group A and group C (P<0.05). The levels of COR, IL-6, CRP, and GLU were not changed in group A, but increased in group B at T2 ~ T4 compared with that at TO (P < 0. 05 ) , and obviously up-regulated in group C at Tl ~ T4 (P < 0. 05 ) . There were obvious differences between group A and group B and C at T2 and T3 in the levels of IL-6, CRP, and GLU (P < 0. 05 ). The palinesthesia time of group A was obviously less than that in group B and C ( P < 0. 05 ). The ratio of nausea and vomiting postoperation of group A( 12. 50% ) was lower than that of group B(23.08% ) and C(33.33% ) ,P<0. 01. Conclusion TCI of propofol combined with remifentanil can maintain the stable he-modynamics, decrease the injury of C02 pneumoperitoneum and the stress reaction. It is a safe and anesthesia method for laparoscopic cholecystectomy with fast palinesthesia and fewer complications.关键词
腹腔镜胆囊切除术/靶控输注/丙泊酚/瑞芬太尼/应激Key words
laparoscopic cholecystectomy/ target controlled infusion/ propofol/ remifentanil/ stress reaction
分类
医药卫生
