瑞芬太尼复合丙泊酚麻醉对老年腹腔镜手术患者的应用效果及安全性评价

Evaluation of the Effect and Safety of Remifentanil Combined with Propofol Anesthesia in Elderly Patients Undergoing Laparoscopic Surgery

目的:评价瑞芬太尼复合丙泊酚麻醉对老年腹腔镜手术患者的应用效果及安全性。方法:随机择取在某院实施老年腹腔镜手术的100例患者作为研究对象,老年患者手术时间为2019年10月-2020年10月,按照数字表达法均分为对照组和观察组各50例,对照组采用芬太尼复合异氟醚麻醉,观察组采用瑞芬太尼复合丙泊酚麻醉,对比两组老年腹腔镜手术患者的临床指标、恢复时间、痛觉阈值以及不良反应发生率。结果:经过不同麻醉手术后,观察组老年患者的心率、舒张压、收缩压等指标稳定性明显高于对照组老年患者的指标稳定性,差异存在统计学意义(P<0.05);观察组的自主呼吸恢复时间和苏醒时间明显比对照组恢复时间短,差异具有统计学意义(P<0.05);观察组老年患者术后的痛觉阈值明显比对照组痛觉阈值高,两组数据差异存在统计学意义(P<0.05);观察组不良反应发生率为10.0%,对照组不良反应发生率为28.0%,差异存在统计学意义(P<0.05)。结论:将瑞芬太尼复合丙泊酚应用于老年腹腔镜手术患者的麻醉过程,能够发挥出理想的镇痛效果,不会对患者的血流动力学造成较大的影响,具有恢复时间短,不良反应少等特点,具有较高的安全性、有效性,值得积极推广应用。

Objective:To evaluate the effect and safety of remifentanil combined with propofol anesthesia in elderly patients undergoing laparoscopic surgery.Methods:100 patients who underwent elderly laparoscopic surgery in a hospital from October 2019 to October 2020 were randomly selected as the research objects,and they were divided into two groups according to the number expression method.50elderly patients in the control group were given fentanyl combined with isoflurane anesthesia,and 50elderly patients in the observation group were given remifentanil combined with propofol anesthesia.The clinical indicators,recovery time,pain sensation threshold,and incidence of adverse reactions of the two groups of elderly laparoscopic surgery patients were compared.Results:After different anesthesia operations,the conclusions were as follows:The stability of indicators such as heart rate,diastolic blood pressure,and systolic blood pressure of the observation group of elderly patients was significantly higher than that of the control group,and there was statistically significant difference in the surgical indicators of the two groups(P<0.05).The recovery time of spontaneous breathing and the wake-up time of the observation group were significantly shorter than those of the control group,and the difference in recovery time between the two groups of elderly patients was statistically significant(P<0.05).The postoperative pain sensation threshold of elderly patients in the observation group was significantly higher than that of the control group,and the difference between the two groups was statistically significant(P<0.05).The incidence of adverse reactions was 10%in the observation group,and 28%in the control group,and the difference in the incidence of adverse reactions between the two groups of elderly patients undergoing laparoscopic surgery was statistically significant(P<0.05).Conclusion:The application of remifentanil combined with propofol anesthesia in elderly patients undergoing laparoscopic surgery can exert an ideal analgesic effect,and will not have a large impact on the patient’s hemodynamics,with short recovery time,few adverse reactions,and high safety and effectiveness,which is an application worthy of active promotion.