异丙酚麻醉与异氟醚吸入麻醉在腹腔镜下胆囊切除术中的麻醉效果及对认知功能的影响  

Anesthetic Effect of Propofol Anesthesia and Isoflurane Inhalation Anesthesia in Laparoscopic Cholecystectomy and its Effect on Cognitive Function

作　　者：李辉 王赢 LI Hui;WANG Ying(Department of Anesthesiology,Wanzai County People's Hospital,Wanzai 336100,Jiangxi,China)

机构地区：[1]万载县人民医院麻醉科,江西万载336100

出　　处：《医学信息》2024年第15期99-102,共4页Journal of Medical Information

摘　　要：目的研究异丙酚麻醉与异氟醚吸入麻醉在腹腔镜下胆囊切除术(LC)中的麻醉效果及对患者认知功能的影响。方法选取2020年1月-2023年3月万载县人民医院拟行LC治疗的60例患者,按照随机数字表法分为异丙酚组(30例)与异氟醚组(30例)。异丙酚组采用异丙酚泵注麻醉,异氟醚组则应用异氟醚吸入麻醉,比较两组麻醉效果[警觉-镇静量表(OAAS)]、血流动力学水平[平均动脉压(MAP)和心率(HR)]、麻醉苏醒时间(睁眼时间、拔管时间、定向力恢复时间)、术后认知功能[简易精神状态检查量表(MMSE)评分、术后认知功能下降发生率、术后认知功能障碍发生率]。结果两组不同时间点OAAS评分比较,差异无统计学意义(P>0.05);异氟醚组气腹后5 min、手术结束时MAP高于异丙酚组,HR低于异丙酚组(P<0.05);异氟醚组睁眼时间、拔管时间、定向力恢复时间短于异丙酚组(P<0.05);异氟醚组术后MMSE评分低于异丙酚组,术后认知功能下降发生率高于异丙酚组(P<0.05)。结论异丙酚麻醉与异氟醚吸入麻醉均可为LC治疗提供良好麻醉条件,二者麻醉效果相当,但后者更有利于患者围术期血流动力学稳定,且苏醒更快,但存在一定术后认知功能下降风险。Objective To study the anesthetic effect of propofol anesthesia and isoflurane inhalation anesthesia in laparoscopic cholecystectomy(LC)and its effect on cognitive function of patients.Methods From January 2020 to March 2023,60 patients undergoing LC in Wanzai County People's Hospital were selected and divided into propofol group(30 patients)and isoflurane group(30 patients)according to the random number table method.The propofol group was given propofol pump injection anesthesia,and the isoflurane group was given isoflurane inhalation anesthesia.The anesthetic effect[alertness-sedation scale(OAAS)],hemodynamic level[mean arterial pressure(MAP)and heart rate(HR)],anesthesia recovery time(eye opening time,extubation time,orientation recovery time),postoperative cognitive function[Mini-mental State Examination Scale(MMSE)score,incidence of postoperative cognitive decline,incidence of postoperative cognitive dysfunction]were compared between the two groups.Results There was no significant difference in OAAS score between the two groups at different time points(P>0.05).The MAP at 5 min after pneumoperitoneum and at the end of operation in the isoflurane group was higher than that in the propofol group,and the HR was lower than that in the propofol group(P<0.05).The eye opening time,extubation time and orientation recovery time in the isoflurane group were shorter than those in the propofol group(P<0.05).The postoperative MMSE score in the isoflurane group was lower than that in the propofol group,and the incidence of postoperative cognitive decline was higher than that in the propofol group(P<0.05).Conclusion Both propofol anesthesia and isoflurane inhalation anesthesia can provide good anesthesia conditions for LC treatment.The anesthetic effects of the two are comparable,but the latter is more conducive to perioperative hemodynamic stability and faster recovery,but there is a certain risk of postoperative cognitive decline.

关 键 词：腹腔镜下胆囊切除术 麻醉效果 异丙酚 异氟醚 认知功能 血流动力学 

分 类 号：R614[医药卫生—麻醉学]