瑞芬太尼复合丙泊酚麻醉对右半结肠癌患者各时间点血压、心率变化及术后苏醒时间的影响

Effects of remifentanil compounded with propofol anesthesia on blood pressure and heart rate changes at various time points and postoperative awakening time in patients with right hemi-colon cancer

目的:分析瑞芬太尼复合丙泊酚麻醉在右半结肠癌(Right-sided colon cancer,RCC)患者治疗中的应用价值。方法:选取2020年1月至2022年1月本院收治的92例RCC患者作为研究对象,依据麻醉方式分为观察组(n=47)和对照组(n=45)。观察两组术后恢复情况、不良反应发生情况,uMEC15S型病人监护仪记录两组麻醉前(T0)、术后10 min(T1)、拔管后10 min(T3)血流动力学指标心率(Heart rate,HR)、舒张压(Diastolic blood pressure,DBP)、收缩压(Systolic blood pressure,SBP),以视觉模拟评估量表(Visual analogue scale VAS)评估两组术后1 h、3 h、6 h疼痛程度,免疫比浊法检测术前、术后6 h、术后12 h的免疫球蛋白(Immunoglobulin A,IgA)、IgM、IgG水平。结果:观察组睁眼时间、拔管时间、言语应答时间短于对照组,术后1 h、3 h、6 h VAS评分高于对照组(P<0.05);T1时两组HR、SBP、DBP均明显升高,T2时均明显降低,且观察组低于对照组(P<0.05);术后6 h、12 h两组IgM、IgA、IgG水平持续降低,观察组明显高于对照组(P<0.05);两组不良反应发生率无明显差异(P>0.05)。结论:瑞芬太尼复合丙泊酚麻醉用于RCC手术安全性较高,能稳定血流动力学,减轻免疫功能抑制,有助于术后恢复,但对术后疼痛的影响较小。

Objective:To analyze the value of remifentanil combined with propofol anesthesia in the treatment of patients with right-sided colon cancer(RCC).Methods:Ninety-two patients with RCC admitted to our hospital from January 2020 to January 2022 were selected as study subjects and divided into observation group(n=47)and control group(n=45)according to the anesthesia method.To observe the postoperative recovery and the occurrence of adverse reactions in the two groups,the hemodynamic indexes of heart rate(HR),diastolic blood pressure(DBP),systolic blood pressure(SBP)before anesthesia(T0),10 min after surgery(T1)and 10 min after extubation(T3)were recorded by uMEC15S patient monitor in both groups.Systolic blood pressure(SBP),visual analogue scale VAS was used to assess the pain level of both groups at 1 hour,3 hours and 6 hours postoperatively,and immunoturbidimetric method was used to measure the levels of Immunoglobulin A(IgA),IgM and IgG before,6 hours and 12 hours postoperatively.and IgG levels.Results:In the observation group,the time of eye opening,time of extubation,and time of verbal response were shorter than those in the control group,and the VAS scores at 1 hour,3 hours,and 6 hours after surgery were higher than those in the control group(P<0.05);HR,SBP,and DBP were significantly higher in both groups at T1,and significantly lower at T2,and the observation group was lower than the control group(P<0.05);the levels of IgM,IgA,and IgG in both groups at 6 hours and 12 hours after surgery continued to The levels of IgM,IgA and IgG in the two groups continued to decrease at 6 hours and 12 hours after surgery,and the observation group was significantly higher than the control group(P<0.05);there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Remifentanil combined with propofol anesthesia is safer for RCC surgery,stabilizes hemodynamics,reduces immune function suppression,and contributes to postoperative recovery,but has less effect on postoperative pain.