七氟醚静吸复合麻醉在腹腔镜胆囊切除术中的应用效果  

Practical effect of sevoflurane intravenous-inhalation combined anesthesia in laparoscopic cholecystectomy

作　　者：曾亮亮 钟宝琼 曾舒 ZENG Liang-liang;ZHONG Bao-qiong;ZENG Shu(Department of Anesthesia,Liaobu Hospital,Dongguan 523400,China)

机构地区：[1]东莞市寮步医院麻醉科,523400

出　　处：《中国实用医药》2021年第12期18-21,共4页China Practical Medicine

摘　　要：目的探究在腹腔镜胆囊切除术中应用七氟醚静吸复合麻醉的效果。方法 66例行腹腔镜胆囊切除术的患者,随机分为实验组及对照组,各33例。实验组应用七氟醚静吸复合丙泊酚和瑞芬太尼麻醉,对照组应用丙泊酚复合瑞芬太尼全凭静脉麻醉。对比两组患者的麻醉效果、血流动力学指标[入室后(T0)、气腹后5 min(T1)、手术结束时(T2)时的心率、收缩压、舒张压]、自主呼吸恢复时间、苏醒时间、拔管时间、视觉模拟评分法(VAS)评分、不良反应发生情况。结果两组患者的麻醉优良率均为100.0%,对比差异无统计学意义(P>0.05)。T0时,实验组患者的心率(75.32±10.58)次/min、收缩压(112.32±12.58)mm Hg(1 mm Hg=0.133 kPa)、舒张压(78.32±8.38)mm Hg与对照组的(75.40±10.67)次/min、(113.36±13.59)mm Hg、(77.36±8.46)mm Hg对比差异无统计学意义(P>0.05)。T1时,实验组患者的心率(73.36±12.74)次/min、收缩压(114.48±12.65)mm Hg、舒张压(75.32±10.36)mm Hg均低于对照组的(91.25±11.69)次/min、(132.25±13.02)mm Hg、(85.36±11.95)mm Hg,差异具有统计学意义(P<0.05);T2时,实验组患者的心率(76.36±5.25)次/min、收缩压(120.21±14.36)mm Hg、舒张压(79.36±9.85)mm Hg与对照组的(76.69±6.68)次/min、(121.29±14.98)mm Hg、(79.40±8.48)mm Hg对比差异无统计学意义(P>0.05)。实验组患者的自主呼吸恢复时间、苏醒时间、拔管时间分别为(5.72±1.13)、(6.15±2.13)、(6.69±1.36)min,略短于对照组的(6.26±2.25)、(7.05±3.36)、(7.10±2.58)min,但差异无统计学意义(P>0.05)。实验组患者术后1、6、12 h的VAS评分分别为(4.24±0.31)、(3.65±0.02)、(2.42±0.61)分,均低于对照组的(5.32±0.25)、(4.47±0.21)、(3.52±0.81)分,差异具有统计学意义(P<0.05)。实验组患者的不良反应发生率为6.06%,低于对照组的24.24%,差异具有统计学意义(P<0.05)。结论在腹腔镜胆囊切除术中应用七氟醚静吸复合麻醉具有良好的可行性。Objective To investigate the effect of sevoflurane intravenous-inhalation combined anesthesia in laparoscopic cholecystectom y.Methods A total of 66 patients undergoing laparoscopic cholecystectomy were randomly divided into experimental group and control group,with 33 cases in each group.The experimental group received sevoflurane inhalation combined with propofol and remifentanil anesthesia,and the control group received propofol combined with remifentanil total intravenous anesthesia.The anesthesia effect,hemodynamic parameters heart rate,systolic blood pressure and diastolic blood pressure after entering the operating room(T_(0)),5 min after pneumoperitoneum(T_(1)),and at the end of the operation(T_(2)),spontaneous breathing recovery time,wake-up time,extubation time,visual analogue scale(VAS)score,and occurrence of adverse reactions were compared between the two groups.Results The excellent-good rates of anesthesia of the two groups were both 100.0%,and the difference was not statistically significant(P>0.05).At T_(0),the heart rate(75.32±10.58)beats/min,systolic blood pressure(112.32±12.58)mm Hg(1mmHg=0.133 kPa)and diastolic Wood pressure(78.32±8.38)mm Hg of the experimental group had no statistically significant difference compared with(75.40±10.67)beats/min,(113.36±13.59)mm Hg and(77.36±8.46)mmHg of the control group(P>0.05).At T_(1),the heart rate(73.36±12.74)beats/min,systolic blood pressure(114.48±12.65)mm Hg and diastolic blood pressure(75.32±10.36)mm Hg of the experimental group were lower than(91.25±11.69)beats/min,(132.25±13.02)mm Hg and(85.36±11.95)mm Hg of the control group,and the difference was statistically significant(P<O.05).At T_(2),the heart rate(76.36±5.25)beats/min,systolic blood pressure(120.21±14.36)mm Hg and diastolic blood pressure(79.36±9.85)mm Hg of the experimental group had no statistically significant difference compared with(76.69±6.68)beats/min,(121.29±14.98)mmHg and(79.40±8.48)mm Hg of the control group(P>0.05).The spontaneous breathing recovery time,wake-up

关 键 词：腹腔镜胆囊切除术 七氟醚 瑞芬太尼 复合麻醉 疼痛视觉模拟评分 

分 类 号：R614[医药卫生—麻醉学]