异丙酚-瑞芬太尼对妇科腹腔镜手术患者血压、心率的影响  

作　　者：邵玮 

机构地区：[1]浙江省舟山市普陀区人民医院

出　　处：《浙江临床医学》2022年第3期438-440,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨异丙酚-芬太尼在妇科腹腔镜手术患者中的麻醉效果及对收缩压(SBP)、舒张压(DBP)、心率(HR)的影响。方法选择2017年7月至2020年5月妇科腹腔镜手术患者132例,随机数字表法分为2组,各66例。对照组采用瑞芬太尼联合七氟醚静吸复合麻醉,观察组采用异丙酚复合瑞芬太尼麻醉,术后3d对患者麻醉效果进行评估,比较两组SBP、DBP、HR水平、术后恢复时间、认知功能、不良反应。结果两组在麻醉诱导前(T_(0))、插管前(T_(1))、插管后即刻(T_(2))、术毕时(T_(3))、拔管时(T_(4))时间点SBP、DBP、HR水平均低于T_(0)时间点(P<0.05);观察组T_(1)、T_(2)时间点SBP、DBP、HR水平均高于对照组(P<0.05);观察组拔管、自主呼吸恢复、定向力恢复时间均短于对照组(P<0.05);两组拔管后1 h、3 h MMSE评分低于术前(P<0.05);观察组拔管后1 h、3 h及24 h MMSE评分均高于对照组(P<0.05);两组麻醉期间不良反应发生率差异无统计意义(P>0.05)。结论异丙酚-瑞芬太尼用于妇科腹腔镜手术患者中对患者SBP、DBP、HR水平影响较小,可获得良好的麻醉效果,患者术后认知功能较为稳定,未增加不良反应发生率,值得推广应用。Objective To investigate the anesthesia effect of propofol-fentanyl in patients undergoing gynecological laparoscopic surgery and its influence on systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)levels.Methods 132 patients undergoing gynecological laparoscopic surgery from July 2017 to May 2020 were selected as subjects,and they were divided into two groups by random number table,with 66 cases in each group.The control group was anesthetized with remifentanil combined with sevoflurane intravenous inhalation,and the observation group was anesthetized with propofol combined with remifentanil.The anesthesia effect of the patients was evaluated 3 days after the operation,and the levels of SBP,DBP,HR and anesthesia were compared between the two groups.Effects,cognitive function,adverse reactions.Results The levels of SBP,DBP and HR at the time points before induction of anesthesia(T_(0)),before intubation(T_(1)),immediately after intubation(T_(2)),end of operation(T_(3)),and extubation(T_(4))in the two groups Lower than To time point(P<0.05);SBP,DBP,and HR levels at T_(1) and T_(2) time points in the observation group were higher than those in the control group(P<0.05);The observation group had shorter extubation,recovery of spontaneous breathing,and recovery of orientation In the control group(P<0.05);The MMSE scores of the two groups were lower at 1 h and 3 h after extubation than those before the operation(P<0.05);The MMSE scores of the observation group were higher than those of the control group at 1 h,3 h and 24 h after extubation(P<0.05);The incidence of adverse reactions during anesthesia in the two groups was not statistically significant(P>0.05).Conclusion The use of propofol-remifentanil in patients undergoing gynecological laparoscopic surgery has little effect on the levels of SBP,DBP,and HR,and good anesthesia effects can be obtained.The postoperative cognitive function of the patients is relatively stable,and adverse reactions are not increased,therefore is worthy of promotio

关 键 词：妇科腹腔镜手术 异丙酚 麻醉效果 瑞芬太尼 收缩压 舒张压 心率 认知功能 

分 类 号：R61[医药卫生—外科学]