探析七氟醚和异丙酚全身麻醉在腹腔镜胆囊切除术中的应用价值及对血流动力学的影响

The Application Value of Sevoflurane and Propofol General Anesthesia in Laparoscopic Cholecystectomy and Its Effect on Hemodynamics

目的 探析七氟醚和异丙酚全身麻醉在腹腔镜胆囊切除术中的应用价值及对血流动力学的影响。方法选取2019年10月—2021年10月临沂金锣医院收治的接受腹腔镜胆囊切除术治疗的110例患者,按照随机数表法分为对照组、观察组,各55例。对照组以异丙酚全身麻醉,观察组以七氟醚全身麻醉。对比两组血流动力学、应激反应、麻醉相关指标及不良反应发生情况。结果 插管后5 min、术后即刻,两组平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO)等血流动力学指标均有所降低,皮质醇、血管紧张素Ⅱ等应激反应指标均有所上升,且两组间上述指标比较,差异有统计学意义(P<0.05);观察组苏醒时间、自主呼吸恢复时间短于对照组,止痛时间长于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率(3.64%)低于对照组(20.00%),差异有统计学意义(χ^(2)=7.066,P=0.008)。结论 与异丙酚相比,七氟醚全身麻醉在腹腔镜胆囊切除术中应用效果更好,安全性更高,更利于维持血流动力学稳定,减轻患者机体应激反应,对促使手术顺利进行、保障手术效果有积极作用,值得推广。

Objective To investigate the application value and hemodynamic effects of sevoflurane and propofol general anesthesia in laparoscopic cholecystectomy.Methods 110 patients who received laparoscopic cholecystectomy in Linyi Jinluo Hospital from October 2019 to October 2021 were selected and divided into control group and observation group according to the random number table method, with 55 cases each. The control group was anesthetized with propofol and the observation group was anesthetized with sevoflurane. The hemodynamics, stress response, anesthesiarelated indicators and adverse reactions were compared between the two groups.Results Five minutes after intubation and immediately after intubation, hemodynamic indexes such as mean arterial pressure(MAP), heart rate(HR), and blood oxygen saturation(SpO) were decreased in both groups, cortisol, angiotensin Ⅱ and other stress response indexes all increased, and the above indicators were compared between the two groups, the difference was statistically significant(P<0.05);the recovery time and spontaneous breathing recovery time of the observation group were shorter than those of the control group, and the pain relief time was longer than that of the control group, and the differences were statistically significant(P<0.05);the incidence of adverse reactions in the observation group(3.64%) was lower than that in the control group(20.00%), and the difference was statistically significant(χ^(2)=7.066, P=0.008).Conclusion Compared with propofol, sevoflurane general anesthesia has better effect and higher safety in laparoscopic cholecystectomy. It is more conducive to maintaining hemodynamic stability, reducing the stress response of the patient’s body, and has a positive effect on promoting the smooth operation of the operation and ensuring the effect of the operation, which is worthy of promotion.