无阿片类药物全身麻醉在妇科腹腔镜手术患者中的应用效果  

Effect of general anesthesia without opiates in gynecological patients undergoing laparoscopy

作　　者：游敏吉[1] 吴继敏[1] 翁晓华[1] 代虹 You Minji;Wu Jimin;Weng Xiaohua;Dai Hong(Department of Anesthesiology,Lishui People′s Hospital,Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市人民医院麻醉科,浙江丽水323000

出　　处：《中国药物与临床》2023年第6期345-349,共5页Chinese Remedies & Clinics

基　　金：浙江省医药卫生科技计划项目(2022ZH023);浙江省医学会临床科研基金(2017ZYC-A131);浙江省丽水市人才项目(2023047929)。

摘　　要：目的 分析无阿片类药物全身麻醉在妇科腹腔镜手术患者中的应用效果。方法 前瞻性选取2022年1月至2023年3月浙江省丽水市人民医院麻醉科行妇科腹腔镜手术的患者96例,按照随机数字表法分成对照组48例、观察组48例。对照组采取常规阿片类药物全身麻醉,观察组采取无阿片类药物全身麻醉,比较2组应用效果。结果 观察组麻醉复苏室停留时间长于对照组,差异有统计学意义(P<0.05)。气管拔管后即刻,观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、自然杀伤细胞及白细胞介素-10水平高于对照组,白细胞介素-6水平低于对照组,差异有统计学意义(P<0.05)。观察组术后恶心、呕吐发生率明显低于对照组,差异有统计学意义(P<0.05)。结论 无阿片类药物全身麻醉虽然会导致妇科腹腔镜手术患者麻醉复苏室停留时间延长,但有助于减轻手术应激、减轻细胞免疫功能抑制作用及改善术后炎症状态,并降低恶心、呕吐的发生风险。Objective To analyze the effects of general anesthesia without opioids in gynecological patients undergoing Laparoscopy.Methods A total of 96 patients who underwent gynecological laparoscopy in the Anesthesia Department of Lishui People′s Hospital were selected from January 2022 to March 2023,and were divided into control group(48 cases)and observation group(48 cases)in accordance with the method of randomized numerical table.The control group received general anesthesia with conventional opioid drugs,while the observation group received general anesthesia without opioid drugs,the application effects of the two groups were compared.Results The observation group had significantly longer stay time in the anesthesia and resuscitation room than the control group,and the difference was statistically significant(P<0.05).Immediately after tracheal extubation,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),natural killer cells and interleukin-10 in the observation group were higher than those in the control group,and the levels of interleukin-6 were lower than those in the control group,the difference was statistically significant(P<0.05).The incidence of postoperative nausea and vomiting in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Although opioid free general anesthesia leads to a prolonged stay in the anesthesia and resuscitation room of gynecological patients undergoing laparoscopy,helps to reduce the stress of surgery,attenuate the inhibition of cellular immune function,improve the postoperative inflammatory status,and reduce the risk of nausea and vomiting.

关 键 词：镇痛药 阿片类 麻醉 全身 腹腔镜检查 功能恢复 

分 类 号：R614[医药卫生—麻醉学]