丙泊酚复合瑞芬太尼麻醉对胆囊结石患者腹腔镜手术术中血流动力学及术后苏醒时间的影响分析  

Analysis of the Effects of Propofol Combined with Remifentanil Anesthesia on Intraoperative Hemodynamics and Postoperative Awakening Time in Laparoscopic Surgery for Gallstones

作　　者：李世建[1] LI Shijian(Department of Anesthesiology,Huojia County People's Hospital,Xinxiang Henan 453800,China)

机构地区：[1]获嘉县人民医院麻醉科,河南新乡453800

出　　处：《临床研究》2025年第5期68-71,共4页Clinical Research

摘　　要：目的研究丙泊酚复合瑞芬太尼麻醉对胆囊结石患者腹腔镜手术术中血流动力学及苏醒时间的影响,为临床提供参考。方法选取2022年8月至2024年3月获嘉县人民医院收治的66例胆囊结石患者进行研究,所有患者均行腹腔镜手术治疗,按随机数表法将患者分为对照组和观察组,各33例。对照组患者术中采用丙泊酚复合芬太尼麻醉;观察组患者术中采用丙泊酚复合瑞芬太尼麻醉。比较两组患者血流动力学水平、术后疼痛情况、应激反应情况、术后苏醒情况及术后并发症发生情况。结果两组患者麻醉诱导前(T0)平均动脉压(MAP)、心率(HR)和血氧饱和度(SpO_(2))水平比较,差异无统计学意义(P>0.05);插管5 min(T_(1))、切皮时(T_(2))、术毕时(T_(3)),观察组患者MAP、HR水平均明显低于对照组,SpO_(2)水平均明显高于对照组,差异有统计学意义(P<0.05)。观察组患者术后1 h、6 h、12 h及24 h的视觉模拟评分法(VAS)评分均明显低于对照组,差异有统计学意义(P<0.05)。两组患者T0时去甲肾上腺素、肾上腺素及皮质醇水平比较,差异无统计学意义(P>0.05);T_(1)~T_(3)时,观察组患者去甲肾上腺素、肾上腺素及皮质醇水平均明显低于对照组,差异有统计学意义(P<0.05)。观察组患者自主呼吸恢复时间、定向能力恢复时间、苏醒时间及拔管时间均短于对照组,差异有统计学意义(P<0.05)。观察组患者术后并发症发生率(6.06%)与对照组(9.09%)比较,差异无统计学意义(P>0.05)。结论丙泊酚复合瑞芬太尼应用于胆囊结石腹腔镜手术患者的麻醉效果好,血流动力稳定,应激反应小,苏醒时间短,镇痛效果好且安全性高,值得临床应用。Objective To study the effects of propofol combined with remifentanil anesthesia on intraoperative hemodynamics and awakening time in patients undergoing laparoscopic surgery for gallstones,providing a reference for clinical practice.Methods From August 2022 to March 2024,66 patients with gallstones treated in Huojia County People's Hospital were selected for the study.All patients underwent laparoscopic surgery and were randomly divided into a control group and an observation group,with 33 cases in each.The control group received propofol combined with fentanyl anesthesia during surgery,while the observation group received propofol combined with remifentanil anesthesia.Hemodynamic levels,postoperative pain,stress response,awakening time,and postoperative complications were compared between the two groups.Results There was no statistically significant difference in mean arterial pressure(MAP),heart rate(HR),and blood oxygen saturation(SpO_(2))levels between the two groups before anesthesia induction(T0)(P>0.05).At 5 minutes after intubation(T_(1)),during skin incision(T_(2)),and at the end of surgery(T_(3)),the MAP and HR levels in the observation group were significantly lower than those in the control group,while SpO_(2) levels were significantly higher,with statistically significant differences(P<0.05).The visual analogue scale(VAS)scores of the observation group at 1 hour,6 hours,12 hours,and 24 hours after surgery were significantly lower than those of the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in norepinephrine,epinephrine,and cortisol levels between the two groups at T0(P>0.05);however,at T_(1)~T_(3),these levels were significantly lower in the observation group compared to the control group,with statistically significant differences(P<0.05).The recovery times of spontaneous breathing,orientation,awakening,and extubation in the observation group were shorter than those in the control group,with statistically significant differences

关 键 词：丙泊酚 瑞芬太尼 胆囊结石 腹腔镜 麻醉 

分 类 号：R364.25[医药卫生—病理学]