Influence of different doses of remifentanil on postoperative hemodynamics in patients undergoing laparo-scopic total hysterectomy / 中国基层医药

ABSTRACT

Objective To study the influence of different doses of remifentanil on postoperative hemodynam -ics in patients undergoing laparoscopic total hysterectomy.Methods Ninety patients underwent laparoscopic total hysterectomy in Weihai Municipal Hospital were selected as the subjects ,and they were divided into A group (0.2μg/kg· min remifentanil),B group(0.3μg/kg· min remifentanil),C group (0.5μg/kg· min remifentanil) according to the random number table method ,with 30 cases in each group.The relative operative indicators (including operation time,anesthesia time,extubation time and analgesia time ) of the three groups were compared ,and compared the heart rate (HR) and mean arterial pressure (MAP) in the three groups at different stages (T0preoperation,T1immedi-ately after operation,T2one day after operation,T3three days after operation).The adverse reactions were recorded and compared.Results There were no statistically significant differences on relative operative indicators among the three groups (F＝1.278,1.346,0.987,2.232,all P＞0.05).The levels of HR and MAP in A group ,B group and C group at T1 were ( 94.68 ±8.51) times/min and (105.84 ±11.37 ) mmHg, ( 81.82 ±9.17 ) times/min and (97.14 ±9.02)mmHg,(75.24 ±8.29)times/min and (82.39 ±10.87)mmHg,respectively.The levels of HR and MAP in A group were higher than those in B group and C group (t＝5.630,3.283,8.962,8.165,all P＜0.05).The levels of HR and MAP in B group were higher than those in C group (t＝2.915,5.720,all P＜0.05).The HR and MAP of A group at T1 were higher than those of T0,T2 and T3 (t＝7.118,6.249,6.977,all P＜0.05,t＝3.632, 3.728,3.717,all P＜0.05).The HR and MAP of C group at T1 were lower than those of T0,T2 and T3 (t＝2.060, 2.043,2.068,all P＜0.05,t＝5.429,5.549,5.341,all P＜0.05).There were no statistically significant differences in HR and MAP of B group at T0,T2 and T3 (t＝1.408,0.529,1.106,all P＞0.05,t＝0.480,0.430,0.437,all P＞0.05).There was no statistically significant difference in the total incidence of adverse reactions among the three groups (χ2＝3.069,P ＞0.05).Conclusion Different doses of remifentanil have great impact on postoperative hemodynamics undergoing laparoscopic total hysterectomy ,while the dose of 0.3μg/kg· min is stable,which is worthy of attention.