七氟烷联合瑞芬太尼在腹腔镜手术麻醉中的应用

Application of Sevoflurane and Remifentanil in Laparoscopic Surgery Anesthesia

目的:探讨联合应用七氟烷、瑞芬太尼在腹腔镜手术麻醉中的应用及对心率(HR)、呼气末二氧化碳分压(PETCO2)、血氧饱和度(SpO2)、气道峰压(Ppeak)的影响。方法:选择2018年4月-2019年4月在笔者所在医院接受腹腔镜手术的患者82例,按照随机数表法分为两组,各41例。对照组采用丙泊酚联合瑞芬太尼麻醉,观察组采用七氟烷联合瑞芬太尼麻醉。观察两组不同时间点HR、PETCO2、SpO2、Ppeak,并对比两组不同时间点简易精神状态评价量表(MMSE)评分情况。结果:两组麻醉前、拔管时SpO2、PETCO2对比差异无统计学意义(P>0.05),麻醉后5 min、插管时观察组HR、SpO2、PETCO2、Ppeak均优于对照组,差异均有统计学意义(P<0.05)。观察组术后1、12、24 h时MMSE评分均高于对照组,差异均有统计学意义(P<0.05)。结论:七氟烷、瑞芬太尼联合应用于腹腔镜手术麻醉中能够有效改善患者HR水平,且未对PETCO2、SpO2、Ppeak水平产生明显影响,同时可以改善患者术后认知功能。

Objective:To investigate the application of combined Sevoflurane and Remifentanil in laparoscopic surgery anesthesia and its effects on heart rate (HR),end-expiratory carbon dioxide partial pressure (PETCO2),oxygen saturation (SpO2) and airway peak pressure (Ppeak).Method:A total of 82 patients who received laparoscopic surgery in the author’s hospital from April 2018 to April 2019 were selected and divided into two groups according to the random number table method,41 patients in each group.The control group was anesthetized with Propofol combined with Remifentanil and the observation group was anesthetized with Sevoflurane combined with Remifentanil.The HR,PETCO2,SpO2,and Ppeak of the two groups were observed at different time points,and the scores of simple mental state assessment scale (MMSE) were compared between the two groups at different time points.Result:There were no statistically significant differences in SpO2 and PETCO2 between the two groups before anesthesia and during extubation (P>0.05),HR,SpO2,PETCO2 and Ppeak in the observation group were all better than those in the control group 5 min after anesthesia and during intubation,the differences were statistically significant (P<0.05).The MMSE scores in the observation group were higher than those in the control group at 1,12 and 24 h after surgery,the differences were statistically significant (P<0.05).Conclusion:The combination of Sevoflurane and Remifentanil in laparoscopic surgery anesthesia can effectively improve the HR level of patients,and has no obvious effect on the PETCO2、SpO2、Ppeak level,and can improve the postoperative patients of cognitive function.