丙泊酚微量泵输注联合前锯肌平面阻滞对老年胃癌根治术患者麻醉药物用量、术后谵妄及躁动影响  

Effect of propofol micropump infusion combined with serratus anterior plane block on the dosage of anesthetic drugs and postoperative delirium and agitation in elderly patients undergoing gastric cancer radical surgery

作　　者：李静[1] 张春艳[1] 杨奇星[1] LI Jing;ZHANG Chun-yan;YANG Qi-xing(Department of Anesthesiology,Linfen People's Hospital,Linfen Shanxi 041000,China)

机构地区：[1]临汾市人民医院麻醉科,山西临汾041000

出　　处：《临床和实验医学杂志》2024年第20期2234-2238,共5页Journal of Clinical and Experimental Medicine

基　　金：山西省中医药管理局科研项目(编号:2024ZYYB)。

摘　　要：目的探讨丙泊酚微量泵输注联合前锯肌平面阻滞对老年胃癌根治术患者麻醉药物用量、术后谵妄及躁动影响。方法前瞻性选取2021年1月至2023年12月临汾市人民医院收治的80例老年胃癌患者作为研究对象,按照抽签法分为观察组与对照组,每组各40例。所有患者均择期实施胃癌根治术治疗,对照组患者实施单纯全身静脉麻醉,术中采取丙泊酚微量泵注维持麻醉,观察组在对照组基础上增加前锯肌平面阻滞。对比两组麻醉效果,麻醉前(T1)、麻醉后2 min(T2)、手术开始即刻(T3)及手术结束即刻(T4)平均动脉压、血氧饱和度及心率水平变化,对比两组麻醉药物总用量,术后1、6及12 h疼痛及镇静情况,最后对比其谵妄及躁动发生率。结果观察组麻醉效果Ⅰ级患者比率为65.00%,高于对照组(37.50%),观察组麻醉效果Ⅲ级患者比率为2.50%,低于对照组(15.00%),差异均有统计学意义(P<0.05)。观察组T2、T3、T4时MAP水平分别为(80.94±6.26)、(83.37±6.52)、(92.39±5.18)mmHg,均高于对照组[(74.33±4.85)、(76.21±4.42)、(83.72±11.22)mmHg],观察组T2、T3时血氧饱和度分别为(98.84±1.67)%、(98.95±1.56)%,均高于对照组[(93.52±2.52)%、(93.12±1.53)%],观察组T2时心率为(80.36±9.27)次/min,低于对照组[(86.28±7.22)次/min],差异均有统计学意义(P<0.05)。两组患者瑞芬太尼用量比较,差异无统计学意义(P>0.05),观察组患者舒芬太尼、丙泊酚用量分别为(43.32±5.12)μg、(251.63±42.52)mg,均明显低于对照组[(46.02±7.25)μg、(281.68±56.12)mg],差异均有统计学意义(P<0.05)。观察组术后1、6、12 h Ramsay评分(1.62±0.28)、(1.08±0.15)、(0.73±0.16)级,均低于对照组[(2.81±0.31)、(1.52±0.12)、(1.03±0.12)级];观察组术后1、6、12 h VAS评分(3.41±1.23)、(2.44±0.21)、(2.17±0.31)分,均低于对照组[(4.39±1.38)、(3.57±0.11)、(3.03±0.25)分],差异均有统计学意义(P<0.05)。观察组术后谵妄及躁动发生率分�Objective To explore the effects of propofol micropump infusion combined with serratus anterior plane block on the dosage of anesthetic drugs and postoperative delirium and agitation in elderly patients undergoing radical gastrectomy for gastric cancer.Methods A total of 80 elderly patients with gastric cancer admitted to Linfen People's Hospital from January 2021 to December 2023 were prospectively selected as the research objects.According to the lottery method,they were divided into the observation group and the control group,with 40 cases in each group.All patients underwent gastric cancer radical surgery on a scheduled basis,while the control group received simple general intravenous anesthesia and maintained anesthesia with propofol micro pump during the surgery.The observation group received plane block of the serratus anterior muscle in addition to the control group.The anesthesia effects of two groups,including changes in mean arterial pressure,blood oxygen saturation,and heart rate levels before anesthesia(T 1),2 minutes after anesthesia(T 2),immediately at the start of surgery(T 3),and immediately after surgery(T 4)were compared.The total amount of anesthesia used between the two groups,pain and sedation at 1 hour,6 hours,and 12 hours after surgery were compared.Finally,the incidence of delirium and agitation was compared.Results The proportion of patients with grade I anesthesia effect in the observation group was 65.00%,which was higher than that in the control group(37.50%),the proportion of patients with gradeⅢanesthesia effect in the observation group was 2.50%,which was lower than that in the control group(15.00%),the differences were statistically significant(P<0.05).The levels of MAP in the observation group at T 2,T 3 and T 4 were(80.94±6.26),(83.37±6.52)and(92.39±5.18)mmHg,respectively,which were higher than those in the control group[(74.33±4.85),(76.21±4.42)and(83.72±11.22)mmHg],the blood oxygen saturation at T 2 and T 3 were(98.84±1.67)%and(98.95±1.56)%,respectively,which were hi

关 键 词：丙泊酚 微量泵输注 前锯肌平面阻滞 胃癌根治术 

分 类 号：R614[医药卫生—麻醉学] R735.2[医药卫生—外科学]