Xiaoqian Deng, MD, Resident, Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Tao Zhu, MD, Professor, Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Pak J Med Sci. 2014 Sep;30(5):1017-21. doi: 10.12669/pjms.305.5196.
Objective : We aimed to compare the anesthetic characteristics between total intravenous anesthesia (TIVA) using propofol-remifentanil with target control infusion (TCI) and volatile induction and maintenance anesthesia (VIMA) using sevoflurane and sufentanyl for patients undergoing laparoscopic cholecystectomy.
A total of 120 patients undergoing laparoscopic cholecystectomy were randomly assigned to two groups. Patients in group T received TCI of propofol-remifentanil for induction and maintenance. Patients in group S received sevoflurane-sufentanyl for induction and maintenance.
Patients in group S had a significantly faster induction time than patients in group T (109s vs.44s). The emergence time in terms of time to extubation was comparable between the two groups, while the time to eyes opening (419s vs.483s, p=0.006) and duration in PACU were longer in group S (44 min vs.53 min, p=0.017). Ten (17.2%) patients in group S were administered an antihypertensive drug when gallbladder issues were present, while only 1(1.7%) patient needed this drug in group T (p=0.004).More patients in group T than in group S received fentanyl for analgesia in PACU (88%vs.70%, p=0.013). The incidence of postoperative nausea and vomiting (PONV) in PACU was higher in group S than in group T (20% vs.38%, p=0.027).
Both techniques had advantages and disadvantages in laparoscopic cholecystectomy; none of the techniques studied was superior.
我们旨在比较使用丙泊酚-瑞芬太尼靶控输注(TCI)和使用七氟醚-舒芬太尼挥发性诱导和维持麻醉(VIMA)的全静脉麻醉(TIVA)在接受腹腔镜胆囊切除术的患者中的麻醉特征。
总共 120 名接受腹腔镜胆囊切除术的患者被随机分为两组。组 T 患者接受丙泊酚-瑞芬太尼 TCI 用于诱导和维持。组 S 患者接受七氟醚-舒芬太尼用于诱导和维持。
组 S 的诱导时间明显快于组 T(109s 比 44s)。两组患者的苏醒时间(以拔管时间为准)相当,而组 S 的睁眼时间(419s 比 483s,p=0.006)和 PACU 时间(44 分钟比 53 分钟,p=0.017)更长。当存在胆囊问题时,组 S 中有 10(17.2%)名患者需要服用降压药,而组 T 中只有 1(1.7%)名患者需要这种药物(p=0.004)。在 PACU 中,组 T 中需要接受芬太尼镇痛的患者多于组 S(88%比 70%,p=0.013)。PACU 中组 S 的术后恶心和呕吐(PONV)发生率高于组 T(20%比 38%,p=0.027)。
这两种技术在腹腔镜胆囊切除术中有各自的优缺点;没有一种技术具有优势。