丙泊酚复合瑞芬太尼麻醉对腹腔镜下输卵管疾病及卵巢囊肿患者术后意识状态和认知功能的影响

Effect of propofol combined with remifentanil anesthesia on postoperative consciousness and cognitive function in patients with tubal disease and ovarian cyst under laparoscopy

目的探讨丙泊酚复合瑞芬太尼麻醉对腹腔镜下输卵管疾病及卵巢囊肿患者术后意识状态和认知功能的影响。方法选取60例接受腹腔镜下输卵管疾病及卵巢囊肿患者,根据随机数字表法分为对照组与研究组,每组30例。研究组实施丙泊酚复合瑞芬太尼麻醉,对照组实施静脉吸入复合麻醉。比较两组患者麻醉情况、术后意识状态及认知功能情况。结果研究组患者麻醉诱导时间(2.11±1.45)min明显短于对照组的(4.12±1.92)min,差异有统计学意义(P<0.05),两组苏醒时间、定向力恢复时间比较,差异无统计学意义(P>0.05)。研究组患者拔管时、离开手术室、拔管1 h后的清醒镇静量表(OAAS)评分均明显高于对照组,差异有统计学意义(P<0.05)。两组患者在术前、术后1 h、3 h的简易智力状态检查量表(MMSE)评分比较,差异无统计学意义(P>0.05)。结论对腹腔镜下输卵管疾病及卵巢囊肿患者,实施丙泊酚复合瑞芬太尼麻醉起效时间更快,不会影响患者认知功能,可提升苏醒质量,值得临床推广与应用。

Objective To investigate the effects of propofol combined with remifentanil anesthesia on postoperative consciousness and cognitive fimction in patients with tubal disease and ovarian cyst under laparoscopy.Methods 60 patients receiving tubal disease and ovarian cyst under laparoscopy were selected and divided into control group and study group according to random number table method,with 30 cases in each group.The study group received propofol combined with remifentanil anesthesia,and the control group received intravenous inhalation combined anesthesia.Anesthesia,postoperative consciousness and cognitive function were compared between the two groups.Results The anesthesia induction time(2.11±1.45)min in the study group was significantly shorter than that in the control group(4.12±1.92)min,and the difference was statistically significant(P<0.05).There was no statistical significance in the recovery time and orientation time between the two groups(P>0.05).The Awake sedation Scale(OAAS)scores of patients in the study group were significantly higher than those in the control group at extubation,after leaving the operating room and 1 h after extubation,with statistical significance(P<0.05).There was no significant difference between the two groups in the score of the Simple Mental State Examination Scale(MMSE)before surgery,1 h and 3 h after surgery(P>0.05).Conclusion For patients with tubal diseases and ovarian cysts under laparoscopy,propofol combined with remifentanil anesthesia takes faster effect,does not affect patients1 cognitive function,can improve the quality of recovery,and is worthy of clinical promotion and application.