七氟烷和瑞芬太尼在腹腔镜胃肠癌手术患者中的麻醉效果和血流动力学比较  

Anesthetic Effects and Hemodynamics of Sevoflurane and Remifentanil in Patients undergoing Laparoscopic Gastrointestinal Cancer Surgery

作　　者：严伟[1] 杨同文[1] 廖春英[1] Yan Wei;Yang Tongwen;Liao Chunying(Department of Anesthesiology,Beijing Huairou District Hospital of Traditional Chinese Medicine,Beijing 101400,China)

机构地区：[1]北京市怀柔区中医医院麻醉科,北京101400

出　　处：《中外医药研究》2024年第8期3-5,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:探讨七氟烷和瑞芬太尼在腹腔镜胃肠癌手术患者中的麻醉效果及血流动力变化情况。方法:选取2020年2月—2022年9月北京市怀柔区中医医院收治的80例行腹腔镜胃肠癌手术患者为研究对象,根据随机数字表法分为观察组和对照组,各40例。观察组术中使用七氟烷静脉滴注维持麻醉,对照组术中使用瑞芬太尼静脉滴注维持麻醉。比较两组患者麻醉相关指标、苏醒时疼痛评分、不同时间血流动力学指标。结果:观察组苏醒时间、拔管时间、呼吸恢复时间短于对照组,拔管时警觉/躁动(OAA/S)评分低于对照组,差异有统计学意义(P<0.05)。观察组苏醒时及苏醒0.5 h、1 h、2 h后疼痛评分均低于对照组,差异有统计学意义(P<0.05)。两组患者手术前、插管后5 min、建立人工气腹后5 min和手术结束时平均动脉压(MAP)、心率(HR)水平比较,差异无统计学意义(P>0.05);插管时观察组MAP和HR水平均明显低于对照组,差异有统计学意义(P<0.05)。结论:相比于瑞芬太尼,在行腹腔镜胃肠癌手术麻醉中使用七氟烷可缩短患者苏醒时间和拔管时间,减轻苏醒后疼痛评分,保持患者血流动力学稳定。Objective:To investigate the anesthetic effect and hemodynamic changes of sevoflurane and remifentanil in laparo⁃scopic gastrointestinal cancer surgery.Methods:A total of eighty patients undergoing laparoscopic gastrointestinal cancer surgery admitted to Beijing Huairou District Hospital of Traditional Chinese Medicine from February 2020 to September 2022 were se⁃lected as the study objects,and were divided into observation group and control group according to random number table method,with forty cases in each group.Sevoflurane intravenous infusion was used to maintain anesthesia in the observation group,remifen⁃tanil intravenous infusion was used to maintain anesthesia in the control group.Anesthesia-related indexes,pain score at recovery and hemodynamic indexes at different time were compared between the two groups.Results:The recovery time,extubation time and respiratory recovery time of the observation group were shorter than those of the control group,and the score of vigilance/agita⁃tion(OAA/S)during extubation was lower than that of the control group,with statistical significance(P<0.05);the pain scores of the observation group were lower than those of the control group at the time of awakening and 0.5 h,1 h and 2 h after awakening,and the difference was statistically significant(P<0.05);there was no significant difference in mean arterial pressure(MAP)and heart rate(HR)between the two groups before operation,5 min after intubation,5 min after the establishment of artificial pneumo⁃peritoneum and at the end of operation(P>0.05);at the time of intubation,MAP and HR levels in the observation group were sig⁃nificantly lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:Compared with remifentanil,the use of sevoflurane during laparoscopic gastrointestinal cancer surgery can shorten the recovery time and ex⁃tubation time of patients,reduce the pain score after recovery,and maintain the hemodynamic stability of patients.

关 键 词：腹腔镜胃肠癌手术 七氟烷 瑞芬太尼 血流动力学 

分 类 号：R735.2[医药卫生—肿瘤] R735.3[医药卫生—临床医学]