瑞芬太尼与芬太尼复合丙泊酚在短时间的腹腔镜手术中的效果与价值分析

Effect and Value Analysis of Remifentanil and Fentanyl Combined with Propofol in Short-term Laparoscopic Surgery

目的 评估在短时间的腹腔镜手术中应用瑞芬太尼与芬太尼复合丙泊酚的应用效果。方法 方便选择南京医科大学附属江苏盛泽医院在2020年1—12月期间就诊的101例腹腔镜手术患者为研究对象,根据随机数表法进行分组,对照组(n=50)采用芬太尼复合丙泊酚麻醉,研究组(n=51)采用瑞芬太尼复合丙泊酚麻醉,将两组患者麻醉指标、血流动力学指标和不良反应发生率进行比较。结果 与对照组相比,研究组的睁眼时间、恢复自主呼吸时间、拔管时间、定向力恢复时间更短,差异有统计学意义(P<0.05)。麻醉诱导前,两组的收缩压、舒张压和心率对比,差异无统计学意义(P>0.05)。研究组插管后1 min、气腹后3 min、术毕的收缩压、心率均低于对照组,差异有统计学意义(P<0.05)。研究组不良反应(包含恶心、呕吐、血氧饱和度降低、麻醉苏醒躁动、腹痛)发生率(3.92%)低于对照组(18.00%),差异有统计学意义(χ^(2)=5.156,P=0.023)。结论 短时间的腹腔镜手术中应用瑞芬太尼复合丙泊酚麻醉的效果好,不良反应发生率低,可以改善血流动力学指标以及麻醉相关指标。

Objective To evaluate the effect of remifentanil and fentanyl combined with propofol in short-term laparoscopic surgery.Methods Convenient selection 101 patients undergoing laparoscopic surgery in Jiangsu Shengze Hospital Affiliated to Nanjing Medical University from January to December 2020 were selected as the study objects and grouped according to the random number table method.The control group(n=50)was anesthetized with fentanyl combined with propofol,and the study group(n=51)was anesthetized with remifentanil combined with propofol.The anesthesia indexes,hemodynamic indexes and incidence of adverse reactions were compared between the two groups.Results Compared with the control group,the eye opening time,spontaneous breathing recovery time,extubation time and orientation recovery time of the study group were shorter,and the difference was statistically significant(P<0.05).There was no statistically significant difference in systolic blood pressure,diastolic blood pressure and heart rate between the two groups before anesthesia induction(P>0.05).The systolic blood pressure and heart rate of the study group were lower than those of the control group at 1 min after intubation,3 min after pneumoperitoneum and after operation,and the difference was statistically significant(P<0.05).The incidence of adverse reactions(including nausea,vomiting,decreased oxygen saturation,anesthesia recovery agitation,abdominal pain)in the study group(3.92%)was lower than that in the control group(18.00%),and the difference was statistically significant(χ^(2)=5.156,P=0.023).Conclusion The use of remifentanil combined with propofol in short-term laparoscopic surgery has good effect,low incidence of adverse reaction,and can improve hemodynamic indexes and anesthesia related indexes.