全静脉麻醉输注丙泊酚联合阿芬太尼对患者术后疼痛和血流动力学的影响  

Effect of total intravenous anesthesia infusion of propofol combined with afentanil on postoperative pain and hemodynamics

作　　者：殷卓 于生喜[1] 刘明[2] YIN Zhuo;YU Shengxi;LIU Ming(Department of Anesthesiology,Dalian Children's Hospital,Dalian,Liaoning,116000,China;Department of Anesthesiology,the Second Affiliated Hospital of Dalian Medical University,Dalian,Liaoning,116000,China)

机构地区：[1]大连市儿童医院麻醉科,辽宁大连116000 [2]大连医科大学附属第二医院麻醉科,辽宁大连116000

出　　处：《当代医学》2023年第7期105-108,共4页Contemporary Medicine

摘　　要：目的探讨全静脉麻醉输注丙泊酚联合阿芬太尼对患者术后疼痛和血流动力学的影响。方法选取2019年1—12月本院收治的80例拟行全静脉麻醉下腹腔镜阑尾切除术患者作为研究对象,根据麻醉药物不同分为对照组与观察组,各40例。对照组采用丙泊酚联合瑞芬太尼麻醉,观察组采用丙泊酚联合阿芬太尼麻醉,比较两组麻醉效果、血流动力学指标、疼痛程度及血流动力学。结果两组麻醉优良率比较差异无统计学意义;两组血流动力学指标组间、时间及交互比较差异均有统计学意义(P<0.05)。组内比较:观察组各时点心率(HR)、平均动脉压(MAP)、收缩压(SBP)、舒张压(DBP)比较差异均无统计学意义;T_(1)、T_(2)、T_(3)时,对照组HR、MAP、SBP、DBP均高于T_(0)时,差异有统计学意义(P<0.05),T_(1)、T_(2)、T_(3)各时点两两比较差异无统计学意义。组间比较:T0时,两组HR、MAP、SBP、DBP比较差异无统计学意义;T_(1)、T_(2)、T_(3)时,观察组MAP、SBP、DBP均低于对照组,差异有统计学意义(P<0.05)。观察组视觉模拟评分法(VAS)评分低于对照组,唤之睁眼时间、做出指令动作时间与拔管时间均短于对照组,差异有统计学意义(P<0.05)。结论针对全麻患者实施丙泊酚联合阿芬太尼输注可有效稳定患者血流动力学,减轻术后疼痛,缩短患者恢复意识时间,麻醉效果显著,值得临床推广应用。Objective To investigate the effect of total intravenous anesthesia infusion of propofol combined with afentanil on postoperative pain and hemodynamics.Methods 80 patients who were admitted to our hospital from January to December 2019 to undergo laparoscopic appendectomy under total intravenous anesthesia were selected as research subjects,and they were divided into the control group and the observation group according to different anesthetic drugs,with 40 cases in each group.The control group was anesthetised with propofol combined with remifentanil,and the observation group was anesthetised with propofol combined with afentanil,anesthesia effect,hemodynamic indexes,pain degree and hemodynamics were compared between the two groups.Results There was no significant difference in the rate of excellent and good anesthesia between the two groups.There were significant differences in hemodynamic indexes among groups,time and interaction between the two groups(P<0.05);intragroup comparison:there were no significant differences in heart rate(HR),mean arterial pressure(MAP),systolic blood pressure(SBP)and diastolic blood pressure(DBP)at each time point in the observation group;at T_(1),T_(2)and T_(3),HR,MAP,SBP and DBP of the control group were higher than those at T0,the difference was statistically significant(P<0.05),while pairwise comparison at T_(1),T_(2)and T_(3)showed no statistically significant difference;inter-group comparison:at T_(0),there was no significant difference in HR,MAP,SBP and DBP between the two groups;at T_(1),T_(2)and T_(3),MAP,SBP and DBP in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Visual analog scale(VAS)scores in the observation group were lower than those in the control group,and the time of eye opening,command action and extubation were shorter than those in the control group,the differences were statistically significant(P<0.05).Conclusion Propofol combined with afentanil infusion for general anesthesia pati

关 键 词：全静脉麻醉 丙泊酚 舒芬太尼 阿芬太尼 术后疼痛 血流动力学 

分 类 号：R614[医药卫生—麻醉学]