老年腹腔镜手术患者应用瑞芬太尼与七氟烷复合麻醉的效果

Effect of combined anesthesia of remifentanil and sevofluranein elderly patients undergoing laparoscopic surgery

目的观察老年腹腔镜手术患者应用瑞芬太尼与七氟烷复合麻醉的效果。方法选取2019年1月—2020年6月就诊于菏泽医学专科学校附属医院的老年腹腔镜手术患者90例,按照随机数字表法分为对照组(n=45)和观察组(n=45)。对照组应用瑞芬太尼麻醉,观察组应用七氟烷与瑞芬太尼复合麻醉。比较两组各时点SOMCT评分、Steward苏醒评分、拔管、苏醒时间及不良反应。结果两组拔管后1h、3h时SOMCT评分对比发现观察组优于对照组(P<0.05),差异有统计学意义。两组拔管时、拔管15min时Steward苏醒评分对比发现观察组优于对照组(P<0.05),差异有统计学意义。两组拔管、苏醒时间对比发现,观察组优于对照组(P<0.05),差异有统计学意义。两组不良反应率对比发现观察组优于对照组(P<0.05),差异有统计学意义。结论老年腹腔镜手术患者应用七氟烷与瑞芬太尼复合麻醉的效果显著,即对术后短期认知功能影响小,可提升苏醒质量,不良反应少,促进患者术后恢复,值得推广研究。

Objective:To observe the effect of combined anesthesia of remifentanil and sevoflurane in elderly patientsundergoing laparoscopic surgery.Methods:A total of 90 elderly patients undergoing laparoscopic surgery in our hospital fromJamuary 2019 to June 2020 were selected and divided into contmol group(n=45)and observation group(n=45)accordingto random number table method.The contmol group was anesthetised with remifentanil,and the observation group was anes-thetised with combined sevofluwrane and remifentamil.SOMCT score,Steward resuscitation score,extubation,resuscitationtime and adverse reactions were compared between the two groups at each time point.Results;The comparison of SOMCTscores at 1h and 3h after extubation between the two groups showed that the observation group was better than the controlgroup(P<0.05),which was statistically significant.Comparison of Steward recovery scores at extubation and 15min extu-bation between the two groups showed that the observation group was better than the control group(P<0.05),which wasstatistically significant.The comparison of extubation and recovery time between the two groups showed that the observationgroup was better than the control group(P<0.05),which had statistical value.Comparison of adverse reaction rate be-tween the two groups showed that observation group was better than control group(P<0.05),which was statistically sig-nificant.Conclusion:Combined anesthesia of sevoflurane and Remifentanil has a significant effet on postoperative short-term cognitive function in elderly patients undergoing laparoscopic surgery.In other words,it has little influence on postop-erative short-term cognitive function,can improve the quality of recovery,and promote postoperative recovery of patientswith fewer adverse reactions.Therefore,it is worth promoting research.