七氟醚和异丙酚复合瑞芬太尼麻醉在妇科腹腔镜手术中的应用效果分析  

Application effect analysis of Sevoflurane and Propofol combined with Remifentanil anesthesia in gynecological laparoscopic surgery

作　　者：张莹 卢云 况敏良 李文莉 ZHANG Ying;LU Yun;KUANG Minliang;LI Wenli(Department of Anesthesiology,Yichun Maternal and Child Health Hospital,Jiangxi Province,Yichun336000,China;Department of Pediatrics,Yichun Maternal and Child Health Hospital,Jiangxi Province,Yichun336000,China)

机构地区：[1]江西省宜春市妇幼保健院麻醉科,江西宜春336000 [2]江西省宜春市妇幼保健院儿科,江西宜春336000

出　　处：《中国当代医药》2023年第35期37-40,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202212631);江西省宜春市科技计划项目(JXYC2021KSA033)。

摘　　要：目的探讨七氟醚和异丙酚复合瑞芬太尼麻醉在妇科腹腔镜手术中的应用效果。方法选取2021年1月至2022年6月于宜春市妇幼保健院进行妇科手术治疗的96例患者作为研究对象,采用随机数字表法将其分为观察组(n=48)与对照组(n=48)。两组患者均进行腹腔镜手术治疗,对照组采用异丙酚复合瑞芬太尼麻醉,观察组采用七氟醚复合瑞芬太尼麻醉。比较两组术后恢复情况、应激反应[肾上腺素(NE)、皮质醇(Cor)、去甲肾上腺素(NA)]、血流动力学[心率(HR)、血氧饱和度(SpO_(2))、平均动脉压(MAP)]以及药物安全性。结果观察组睁眼时间、自主呼吸恢复时间、定向力恢复时间、言语应答时间、拔管时间均短于对照组,差异有统计学意义(P<0.05)。两组麻醉前NE、Cor、NA、MAP、HR以及SpO_(2)水平比较,差异均无统计学意义(P>0.05)。观察组建立气腹后、术后10 min的NE、Cor、NA、MAP、HR低于对照组,差异有统计学意义(P<0.05)。两组均未发生明显不良反应。结论妇科腹腔镜手术中应用七氟醚复合瑞芬太尼麻醉效果较好,利于减轻应激反应,维持生命体征稳定,术后恢复时间短,且安全性理想,值得临床广泛应用。Objective To investigate the effect of Sevoflurane and Propofol combined with Remifentanil anesthesia in gynecological laparoscopic surgery.Methods Ninety-six patients who underwent gynecological surgery in Yichun Maternal and Child Health Hospital from January 2021 to June 2022 were selected as the research objects,and they were divided into observation group(n=48)and control group(n=48)by random number table method.Both groups were treated with laparoscopic surgery.The control group was anesthetized with Propofol combined with Remifentanil,and the observation group was anesthetized with Sevoflurane combined with Remifentanil.The postoperative recovery,stress response(epinephrine[NE],cortisol[Cor],norepinephrine[NA]),hemodynamics(heart rate[HR],blood oxygen saturation[SpO_(2)],mean arterial pressure[MAP])and drug safety were compared between the two groups.Results The eye opening time,spontaneous breathing recovery time,orientation recovery time,speech response time and extubation time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the levels of NE,Cor,NA,MAP,HR and SpO_(2)before anesthesia between the two groups(P>0.05).The levels of NE,Cor,NA,MAP and HR in the control group after pneumoperitoneum and 10 min after operation were higher than those in the observation group,and the differences were statistically significant(P<0.05).No obvious adverse reactions occurred in both groups.Conclusion Sevoflurane combined with Remifentanil has good anesthetic effect in gynecological laparoscopic surgery,which is beneficial to reduce stress response,maintain stable vital signs,short postoperative recovery time,and ideal safety,and is worthy of clinical application.

关 键 词：妇科腹腔镜手术 七氟醚 异丙酚 瑞芬太尼麻醉 血流动力学 应激反应 

分 类 号：R614[医药卫生—麻醉学]