丙泊酚复合瑞芬太尼靶控输注麻醉对宫颈癌患者血压、心率及预后的影响

Effects of propofol combined with remifentanil target-controlled infusion anesthesia on blood pressure, heart rate and prognosis of patients with cervical cancer

目的探讨丙泊酚复合瑞芬太尼靶控输注麻醉对宫颈癌患者血压、心率及预后的影响。方法选取2015年5月至2018年12月于我院行宫颈癌手术的79例患者为研究对象,按随机数字表法将其分为参照组(39例)和观察组(40例)。参照组采用丙泊酚复合瑞芬太尼持续静脉输注麻醉,观察组采用丙泊酚复合瑞芬太尼靶控输注麻醉。比较两组患者进入手术室即刻(T0)、插管即刻(T1)、手术开始后3 min(T2)、术毕即刻(T3)的收缩压(SBP)、舒张压(DBP)、心率(HR)、拔管后不同时间的镇静情况、拔管时间、苏醒时间及不良反应发生情况。结果观察组T1、T2、T3时刻的SBP、DBP、HR与T0时刻比较,差异不显著(P>0.05);拔管后5、15 min,观察组OAAS评分显著高于参照组(P<0.05);观察组的拔管时间及苏醒时间显著短于参照组(P<0.05)。观察组苏醒期躁动1例(2.50%),参照组苏醒期躁动3例(7.69%),组间比较,差异不显著(P>0.05)。结论宫颈癌患者手术开始后3 min予以丙泊酚复合瑞芬太尼靶控输注麻醉可减轻对血压、心率的影响,且术后苏醒迅速,不良反应少。

Objective To investigate the effects of propofol combined with remifentanil target-controlled infusion anesthesia on blood pressure, heart rate and prognosis of patients with cervical cancer. Methods Seventy-nine patients undergoing cervical cancer surgery in our hospital from May 2015 to December 2018 were selected as the study objects and divided into reference group (39 cases) and observation group (40 cases) according to the random number table method. The reference group received continuous intravenous anesthesia with propofol combined with remifentanil, and the observation group received targeted-controlled anesthesia with propofol combined with remifentanil. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) of immediately after entering the operating room (T0), immediately intubation (T1), 3 min after the operation starting (T2), and immediately after the operation (T3), sedation at different time after extubation, extubation time, recovery time and adverse reactions were compared between the two groups. Results There were no significant differences in SBP, DBP, HR of the observation group between T1, T2, T3 and T0 (P>0.05). At 5 and 15 min after extubation, the OAAS score in the observation group was significantly higher than that in the reference group (P<0.05). The time of extubation and recovery in the observation group were significantly shorter than those in the reference group (P<0.05). There was 1 case (2.50%) of restlessness during recovery in the observation group and 3 cases (7.69%) in the reference group, there was no significant difference between the two groups(P>0.05). Conclusion Propofol combined with remifentanil target-controlled infusion anesthesia at 3 min after the operation starting for patients with cervical cancer can reduce the impact on blood pressure and HR, with faster postoperative recovery and fewer adverse reactions.