Objective To evaluate the changes in noxious stimulation intensity at different periods of pneumoperitoneum in patients undergoing gynecological laparoscopic surgery.Methods Forty-five ASA Ⅰ or Ⅱ patients,aged 25-36 years,with body mass index of 18-23 kg/m2,undergoing elective gynecological laparoscopic surgery,were randomly divided into three groups (n =15 each).In group Ⅰ,anesthesia was maintained with target-controlled infusion (TCI) of remifentanil (with target plasma concentration of 4-6 ng/ml) and propofol (with target plasma concentration of 2 μg/ml),and the concentrations were adjusted according to the changes in blood pressure (BP) and heart rate (HR) to maintain hemodynamics stable.Group Ⅱ and group Ⅲ received inhalation of isoflurane (with the end-tidal concentration of 1％-2％) and TCI of remifentanil (with target plasma concentration of 2-4 ng/ml).TCI of remifentanil was then stopped at 5 minutes before pneumoperitoneum (group Ⅱ) or at 5 minutes after the end of rapid inflation (group Ⅲ

作者：张瑾；刘荣军；高金贵；GUO Jing

来源：中华麻醉学杂志 2014 年 34卷 z1期