腹腔镜手术中椎管内麻醉复合静脉麻醉对子宫肌瘤的应用效果研究  

Study on the effect of intraspinal anesthesia combined with intravenous anesthesia in the treatment of uterine fibroids during laparoscopic surgery

作　　者：何福辉 He Fu-hui(Department of Anesthesiology,Taiqian New District People's Hospital,Puyang 457600,Henan,China)

机构地区：[1]台前县新区人民医院麻醉科,河南濮阳457600

出　　处：《四川生理科学杂志》2024年第10期2282-2284,共3页

摘　　要：目的:探讨椎管内麻醉复合静脉麻醉在子宫肌瘤患者腹腔镜手术中的应用效果。方法:选取2020年7月至2022年7月在本院行腹腔镜手术治疗的90例子宫肌瘤患者作为研究对象。随机将患者分为对照组和观察组,每组各45例。对照组采用全身麻醉;观察组采用椎管内麻醉复合静脉麻醉。分析比较两组麻醉前(T0)、创建气腹后(T1)、手术结束时(T2)的收缩压、心率水平及术后苏醒时间、拔管时间、术后各时点疼痛程度[数字评定量表(Numerical rating scale,NRS评分)]。结果:与T0时点比较,两组T1、T2时收缩压呈上升趋势,对照组心率呈上升趋势,观察组心率呈先上升后下降趋势。两组各时点,组间比较均有显著差异(P<0.05)。观察组的苏醒时间、拔管时间较对照组均明显缩短(P<0.05)。观察组术后12 h、24 h、48 h时NRS评分均明显低于对照组(P<0.05)。结论:子宫肌瘤腹腔镜手术治疗患者应用椎管内麻醉复合静脉麻醉,可稳定患者生命体征,提升麻醉效果,减轻术后疼痛程度。Objective:To investigate the effect of intraspinal anesthesia combined with intravenous anesthesia in laparoscopic surgery for patients with uterine fibroids.Methods:90 patients with uterine fibroids who underwent laparoscopic surgery in our hospital from July 2020 to July 2022 were selected as the study objects.The patients were randomly divided into control group and observation group,45 cases in each group.The control group was given general anesthesia.The observation group was given intraspinal anesthesia combined with intravenous anesthesia.The levels of systolic blood pressure and heart rate before anesthesia(T0),after creating pneumoperitoneum(T1)and at the end of operation(T2),postoperative recovery time,extubation time and pain degree at each time point after operation[Numerical rating scale(NRS score)]were analyzed and compared between the two groups.Results:Compared with the T0 time point,the systolic blood pressure of the two groups increased at T1 and T2,the heart rate of the control group increased,and the heart rate of the observation group increased first and then decreased.There were significant differences in the comparison between the two groups at different time points(P<0.05).The recovery time and extubation time of observation group were significantly shortened compared with control group(P<0.05).NRS scores in the observation group were significantly lower than those in the control group at 12 h,24 h and 48 h after surgery(P<0.05).Conclusion:Intraspinal anesthesia combined with intravenous anesthesia can stabilize vital signs,improve anesthesia effect and reduce postoperative pain in patients with hysteromyoma undergoing laparoscopic surgery.

关 键 词：子宫肌瘤 腹腔镜手术 全身麻醉 椎管内麻醉复合静脉麻醉 

分 类 号：R614[医药卫生—麻醉学] R73[医药卫生—外科学]