舒芬太尼瑞芬太尼分别联合丙泊酚麻醉对子宫肌瘤腹腔镜微创术患者胃肠动力及免疫功能的影响

Effects of sufentanil or remifentanil combined with propofol anesthesia on gastrointestinal motility and immune function in patients with uterine fibroids undergoing laparoscopic minimally invasive surgery

目的 观察舒芬太尼、瑞芬太尼分别联合丙泊酚麻醉对子宫肌瘤腹腔镜微创术患者胃肠动力及免疫功能的影响。方法 选取我院2021年收治需进行子宫肌瘤腹腔镜微创术治疗的子宫肌瘤患者97例,采取随机数字法分成2组,对照组(n=48例,采取舒芬太尼+丙泊酚全身麻醉),观察组(n=49例,采取瑞芬太尼+丙泊酚全身麻醉),比较2组患者术后麻醉情况、胃肠动力、免疫功能及手术应激反应情况。结果观察组术中麻醉剂追加平均次数少于对照组(P<0.05),术后初次平均睁眼时间与平均拔管时间短于对照组(P<0.05),2组术后肛门初次排气时间、初次下床活动时间与术后12 h镇痛效果差异无统计学意义(P>0.05);观察组术后对胃肠动力影响大于对照组(P<0.05);观察组术后对免疫功能的影响小于对照组(P<0.05),观察组术后应激反应轻于对照组(P<0.05)。结论 瑞芬太尼联合丙泊酚麻醉对子宫肌瘤腹腔镜微创术麻醉效果好于舒芬太尼联合丙泊酚,机体免疫功能与应激反应影响小于舒芬太尼联合丙泊酚,但对肠胃动力影响相对较大,两者用于麻醉手术中各有优势。

Objective To observe the effects of sufentanil or remifentanil combined with propofol anesthesia on gastrointestinal motility and immune function in patients with uterine fibroids undergoing laparoscopic minimally invasive surgery.Methods Ninety-seven patients with uterine fibroids who required laparoscopic minimally invasive treatment of uterine fibroids in the hospital were selected between January 2021 and December 2021,and they were divided into two groups by the random number method,including the control group(n=48,sufentanil+propofol for general anesthesia)and the observation group(n=49,remifentanil+propofol for general anesthesia).The postoperative anesthesia,gastrointestinal motility,immune function,and surgical stress response were compared between the two groups of patients.Results The average number of additional intraoperative anesthetics in the observation group was less than that in the control group(P<0.05),and the average postoperative initial eye-opening time and average extubation time were shorter than those in the control group(P<0.05),but there were no significant differences in the postoperative initial anal exhaust time,initial ambulation time and analgesic effect at 12 h after surgery between the two groups(P>0.05).The postoperative effect on gastrointestinal motility in the observation group was greater than that in the control group(P<0.05).The postoperative effect on immune function was smaller in the observation group than in the control group(P<0.05),and the postoperative stress response was milder than that in the control group(P<0.05).Conclusion Remifentanil combined with propofol during laparoscopic minimally invasive surgery for uterine fibroids has a better anesthetic effect than sufentanil combined with propofol and has smaller effects on body′s immune function and stress response than sufentanil combined with propofol.However,it has a relatively greater effect on gastrointestinal motility,and both have their advantages during anesthesia surgery.