七氟烷、丙泊酚分别复合瑞芬太尼对腹腔镜胆囊切除术麻醉效果及苏醒质量的对比研究

Anesthetic effects and recovery qualities of sevoflurane and propofol combined with remifentanil in laparoscopic cholecystectomy

目的分析对比七氟烷、丙泊酚分别复合瑞芬太尼对腹腔镜胆囊切除术患者的麻醉效果及苏醒质量。方法选取辽健集团抚矿总医院于2021年1月至2022年2月收治的104例行腹腔镜胆囊切除术治疗的患者,随机数字表法分为参照组和研究组,各52例。参照组男31例,女21例,年龄(67.28±4.48)岁;研究组男30例,女22例,年龄(66.89±4.31)岁。参照组采用丙泊酚复合瑞芬太尼麻醉,研究组采用七氟烷复合瑞芬太尼麻醉。对比两组心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)、苏醒质量、不良反应总发生率。采用t检验和χ^(2)检验。结果两组T_(0)、T_(4)时刻HR、MAP差异均无统计学意义(均P>0.05),两组T_(1)、T_(2)时刻HR、MAP较T_(0)时刻更低,且研究组HR、MAP较参照组更低(均P<0.05)。研究组自主呼吸恢复时间、睁眼时间、言语应答时间、拔管时间较参照组更短[(6.18±1.10)min比(8.37±1.92)min、(6.69±1.85)min比(10.23±2.17)min、(9.31±2.38)min比(11.45±2.78)min、(9.75±1.85)min比(11.94±3.04)min,t=7.137、8.952、4.217、4.438,均P<0.05]。研究组恶心呕吐、头晕、肌肉僵直、体动反应、呼吸抑制等不良反应总发生率较参照组更低[3.85%(2/52)比17.31%(9/52),χ^(2)=4.981,P<0.05]。结论腹腔镜胆囊切除术患者采用七氟烷复合瑞芬太尼麻醉效果良好,可维持血流动力学平稳,缩短苏醒时间,减少不良反应发生率,值得推广。

Objective To analyze and compare the anesthetic effects and recovery qualities of sevoflurane and propofol combined with remifentanil for patients undergoing laparoscopic cholecystectomy.Methods A total of 104 patients who underwent laparoscopic cholecystectomy in Fumine General Hospital from January 2021 to February 2022 were selected,and divided into a reference group and a study group by the random number table method,with 52 cases in each group.There were 31 males and 21 females in the reference group,and they were(67.28±4.48)years old.There were 30 males and 22 females in the study group,and they were(66.89±4.31)years old.The reference group was anesthetized with propofol and remifentanil,and the study group with sevoflurane and remifentanil.The heart rates(HR),mean arterial pressures(MAP),recovery qualities,and total incidences of adverse reactions were compared between these two groups.t andχ^(2)tests were applied.Results There were no statistical differences in HR's and MAP's at T_(0) and T_(4) between the two groups(all P>0.05).The HR's and MAP's at T_(1) and T_(2) in the two groups were lower than those at T_(0),and the HR's and MAP's in the study group were lower than those in the reference group(allP<0.05).The recovery time of spontaneous breathing,eye opening time,speechresponse time,andextubationtime inthe study groupwere significantly shorter thanthose inthe reference group[(6.18±1.10)min vs.(8.37±1.92)min,(6.69±1.85)min vs.(10.23±2.17)min,(9.31±2.38)min vs.(11.45±2.78)min,and(9.75±1.85)min vs.(11.94±3.04)min;t=7.137,8.952,4.217,and 4.438;all P<0.05].The total incidence of adverse reactions,such as nausea and vomiting,dizziness,muscle stiffness,body movement response,and respiratory depression,in the study group was lower than that in the reference group[3.85%(2/52)vs.17.31%(9/52);χ^(2)=4.981,P<0.05].Conclusion Sevoflurane combined remifentanil has good anesthesia effect on patients undergoing laparoscopic cholecystectomy,and can maintain the stability of hemodynamics,shorten the time of recovery,and reduce the incidence of adverse reactions,so it is worth being generalized.