七氟醚联合瑞芬太尼在老年腹腔镜胆囊切除术患者全身麻醉维持中的应用效果  

Application effects of Sevoflurane combined with Remifentanil in maintenance of general anesthesia in elderly patients undergoing laparoscopic cholecystectomy

作　　者：李林 LI Lin(Department of Anesthesiology of Huaibin County People’s Hospital,Xinyang 464400 Henan,China)

机构地区：[1]淮滨县人民医院麻醉科,河南信阳464400

出　　处：《中国民康医学》2025年第9期73-76,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察七氟醚联合瑞芬太尼在老年腹腔镜胆囊切除术(LC)患者全身麻醉维持中的应用效果。方法:选取2022年1月至2024年1月于该院进行LC的80例老年患者进行前瞻性研究,采用随机数字表法将其分为对照组和观察组各40例。两组均采用全身麻醉,对照组术中采取丙泊酚联合瑞芬太尼维持麻醉,观察组术中采取七氟醚联合瑞芬太尼维持麻醉,比较两组麻醉苏醒时间,不同时间[麻醉诱导前(T_(0))、麻醉诱导后10 min(T_(1))、术毕后30 min(T_(2))]血流动力学指标[舒张压(DBP)、收缩压(SBP)、心率]和脑氧代谢指标[桡动脉-颈内静脉球部血氧含量差值(Da-jvO_(2))、脑氧摄取率(CEO_(2))、颈内静脉球部血氧饱和度(SjvO_(2))]水平,以及不良反应发生率。结果:观察组麻醉苏醒时间短于对照组,差异有统计学意义(P<0.05);T_(0)、T_(2)时,两组DBP、SBP、心率水平比较,差异均无统计学意义(P>0.05);T_(1)时,两组DBP、SBP、心率水平均低于T_(0)时,但观察组高于对照组,差异有统计学意义(P<0.05);两组T_(0)、T_(2)时SjvO_(2)水平与T_(0)时Da-jvO_(2)、CEO_(2)水平比较,差异均无统计学意义(P>0.05);T_(1)时,两组SjvO_(2)水平均高于T_(0)时,且观察组高于对照组,差异有统计学意义(P<0.05);T_(1)、T_(2)时,两组Da-jvO_(2)、CEO_(2)水平均低于T_(0)时,且观察组低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率为5.00%(2/40),低于对照组的20.00%(8/40),差异有统计学意义(P<0.05)。结论:七氟醚联合瑞芬太尼应用于老年LC患者全身麻醉维持可缩短苏醒时间,改善血流动力学指标和脑氧代谢指标水平,降低不良反应发生率,效果优于丙泊酚联合瑞芬太尼维持麻醉。Objective:To observe application effects of Sevoflurane combined with Remifentanil in maintenance of general anesthesia in elderly patients undergoing laparoscopic cholecystectomy(LC).Methods:A prospective study was conducted on 80 elderly patients who underwent laparoscopic cholecystectomy(LC)in this hospital from January 2022 to January 2024.They were divided into control group and observation group by using the random number table method,40 cases in each group.Both groups were treated with general anesthesia.Propofol combined with Remifentanil was used to maintain anesthesia in the control group,while Sevoflurane combined with Remifentanil was used to maintain anesthesia in the observation group.The anesthesia recovery time,the levels of hemodynamic indexes[diastolic blood pressure(DBP),systolic blood pressure(SBP),heart rate]and cerebral oxygen metabolism indexes[radial artery-jugular vein bulb blood oxygen content difference(Da-jvO_(2)),cerebral extraction of oxygen rate(CEO_(2))and internal jugular vein bulb blood oxygen saturation(SjvO_(2))]at different time[before anesthesia induction(T_(0)),10 min after anesthesia induction(T_(1)),30 min after the surgery(T_(2))],and the incidence of adverse reactions were compared between the two groups.Results:The anesthesia recovery time of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.05).At T_(0) and T_(2),there were no significant differences in the levels of DBP,SBP and heart rate between the two groups(P>0.05).At T_(1),the levels of DBP,SBP and heart rate in the two groups were lower than those at T_(0),but those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the SjvO_(2) levels at T_(0) and T_(2),Da-jvO_(2) and CEO_(2) levels at T_(0) between the two groups(P>0.05).At T_(1),the levels of SjvO_(2) in the two groups were higher than those at T_(0),that in the

关 键 词：老年 腹腔镜胆囊切除术 瑞芬太尼 七氟醚 丙泊酚 血流动力学 麻醉苏醒 

分 类 号：R614.2[医药卫生—麻醉学]