七氟烷复合丙泊酚全麻用于老年腹腔镜胆囊切除术的临床价值

Clinical value of sevoflurane combined propofol anesthesia for elderly laparoscopic cholecystectomy

目的研究七氟烷与异氟烷分别复合丙泊酚两种全麻方法在老年腹腔镜胆囊切除术中临床应用价值。方法根据患者入院时间,选取94例实施腹腔镜胆囊切除术的老年患者,按照数字量表法随机分为两组,各47例。观察组患者行七氟烷复合丙泊酚麻醉,对照组患者行异氟烷复合丙泊酚麻醉。比较两组患者术中血流动力学指标以及麻醉质量和术后不良反应。结果术中两组患者不同时间节点平均动脉压(MAP)、心排血量(CO)与心率(HR)差异无统计学意义(P>0.05);与麻醉诱导前相比,气管插管即刻时MAP与HR数值均显著降低,差异有统计学意义(P<0.05);观察组患者苏醒和拔管时间相较于对照组均显著缩短(P<0.05),拔管10分钟后观察组苏醒效果(OAAS)评分总体优于对照组(P<0.05)。不良反应发生率方面两组差异不显著(P>0.05)。结论七氟烷复合丙泊酚全麻用于老年腹腔镜胆囊切除术,有助于术中血流动力学指标的维稳,安全可靠性较高,麻醉效果较好,有效减轻患者康复期不良反应的发生。

Objective To investigate the clinical application value of sevoflurane and isoflurane combined with propofol and general anesthesia in elderly laparoscopic cholecystectomy. Methods According to the time of admission,94 elderly patients undergoing laparoscopic cholecystectomy were randomly divided into two groups according to the digital scale. The patients in the observation group received sevoflurane and propofol anesthesia,and the control group received isoflurane and propofol anesthesia. The intraoperative hemodynamic parameters,anesthesia quality,and postoperative adverse reactions were compared between the two groups. Results There was no significant difference in mean arterial pressure（MAP）,cardiac output（CO）,and heart rate（HR） between the two groups at different time points（P〉0. 05）. Compared with before induction of anesthesia,the values of MAP and HR at the instant of tracheal intubation were significantly decreased,and the difference was statistically significant（P〈0. 05）. The recovery and extubation time of the observation group were significantly shorter than those of the control group（P〈0. 05）,and the observation group＇s recovery effect（OAAS） score was better than the control group after 10 minutes of extubation（P〈0. 05）. There was no significant difference in the incidence of adverse reactions between the two groups（P〉0. 05）. Conclusion Sevoflurane-combined propofol anesthesia for laparoscopic cholecystectomy can help maintain the stability of intraoperative hemodynamic parameters,with high safety and reliability,good anesthetic effect,and effective in reducing adverse reactions in patients with convalescence occur.