针刺辅助麻醉在老年腹腔镜胆囊切除术患者中的应用效果分析  

Analysis of the practical effect of acupuncture assisted anesthesia in elderly patients undergoing laparoscopic cholecystectomy

作　　者：李波 于福玲 LI Bo;YU Fu-ling(Songjiang District Fangta Hospital of Traditional Chinese Medicine,Shanghai 201620,China)

机构地区：[1]上海市松江区方塔中医医院,201620

出　　处：《中国实用医药》2021年第25期18-20,共3页China Practical Medicine

摘　　要：目的分析针刺辅助麻醉在老年腹腔镜胆囊切除术患者中的应用效果。方法196例开展腹腔镜胆囊切除术的老年患者,以抽签法分为对照组和观察组,各98例。对照组采用常规麻醉,观察组常规麻醉前进行针刺辅助麻醉。比较两组手术情况(丙泊酚用量、苏醒时间、拔管时间)、视觉模拟评分法(VAS)评分及不同时段血流动力学指标变化。结果观察组丙泊酚用量(349.88±86.45)mg明显少于对照组的(396.56±88.43)mg,苏醒时间(7.22±1.43)min及拔管时间(11.58±1.75)min明显短于对照组的(13.02±1.67)、(15.53±1.94)min,VAS评分(2.47±0.67)分明显低于对照组的(4.86±0.52)分,差异具有统计学意义(P<0.05)。麻醉前,两组平均动脉压(MAP)及心率(HR)比较差异无统计学意义(P>0.05);观察组气管插管即刻的MAP及HR高于对照组,气腹建立5 min后、气腹建立15 min后、麻醉结束时的MAP及HR低于对照组,差异有统计学意义(P<0.05)。观察组患者的MAP及HR波动明显小于对照组。结论对老年腹腔镜胆囊切除术患者应用针刺辅助麻醉不仅可以更大程度上维持患者麻醉过程中的血流动力学稳定,而且还可以进一步缩短苏醒和拔管时间,减少丙泊酚用量,提高止痛效果。Objective To analyze the practical effect of acupuncture assisted anesthesia in elderly patients undergoing laparoscopic cholecystectomy.Methods A total of 196 elderly patients undergoing laparoscopic cholecystectomy were divided into control group and observation group according to lottery method,with 98 cases in each group.The control group received conventional anesthesia,and the observation group received acupuncture assisted anesthesia before conventional anesthesia.The surgical situation(dosage of propofol,wake-up time,extubation time),visual analogue scale(VAS)score,and changes of hemodynamic parameters at different time points were compared between the two groups.Results The dosage of propofol(349.88±86.45)mg in the observation group was significantly less than(396.56±88.43)mg in the control group,and the wake-up time(7.22±1.43)min and the extubation time(11.58±1.75)min were significantly shorter than(13.02±1.67)and(15.53±1.94)min in the control group,and VAS score(2.47±0.67)points was significantly lower than(4.86±0.52)points in the control group.All the difference was statistically significant(P<0.05).Before anesthesia,there was no statistically significant difference in mean arterial pressure(MAP)and heart rate(HR)between the two groups(P>0.05).MAP and HR in the observation group immediately after tracheal intubation were higher than those of the control group,and MAP and HR at 5 and 15 min after pneumoperitoneum establishment,and at the end of anesthesia were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).The fluctuations of MAP and HR in the observation group were significantly smaller than those in the control group.Conclusion For elderly patients undergoing laparoscopic cholecystectomy,acupuncture assisted anesthesia can not only maintain the hemodynamic stability of patients during anesthesia to a greater extent,but also can further shorten the wake-up time and extubation time,reduce the dosage of propofol and improve the analge

关 键 词：腹腔镜胆囊切除术 针刺 辅助麻醉 血流动力学 

分 类 号：R614[医药卫生—麻醉学]