不同麻醉维持方案在腹腔镜下全子宫切除术中的应用效果

The effects of different anesthesia maintenance programs on the efficacy of laparoscopic total hysterectomy

目的:探讨不同麻醉维持方案在腹腔镜下全子宫切除术中的应用效果。方法:将82例择期行腹腔镜下全子宫切除术的患者随机分为对照组和研究组,各41例。对照组术中使用丙泊酚复合瑞芬太尼维持麻醉,研究组术中使用七氟醚复合瑞芬太尼维持麻醉。对比两组麻醉质量、应激反应指标[皮质醇(Cor)、5-羟色胺(5-HT)]、认知功能[简易精神状态评价量表(MMSE)评分]及术后不良反应发生情况。结果:术后,研究组自主呼吸恢复、苏醒及拔管时间短于对照组;Cor、5-HT水平和不良反应总发生比例低于对照组;MMSE评分高于对照组(P<0.05)。结论:相比丙泊酚复合瑞芬太尼,腹腔镜下全子宫切除术患者采用七氟醚复合瑞芬太尼维持麻醉可提高苏醒质量,减轻应激反应,促使认知功能恢复,且不良反应少。

Objective:To explore the effects of different anesthesia maintenance programs on the efficacy of laparoscopic hysterectomy.Methods:Eighty-two patients undergoing elective laparoscopic hysterectomy were randomly divided into a control group and a study group with 41 cases each.Anesthesia was intraoperatively maintained with propofol combined with remifentanil in the control group and sevoflurane combined with remifentanil in the study group.The quality of anesthesia,stress response indexes[cortisol(Cor),5-hydroxytryptamine(5-HT)],cognitive function[mini-mental state examination(MMSE)score]and the incidence of postoperative adverse reactions were compared between the two groups.Results:Postoperatively,the time to spontaneous breathing,awakening and extubating were shorter,the levels of Cor,5-HT and the incidence of adverse reactions were lower,and the MMSE score was higher in the study group than the control group(P<0.05).Conclusion:Compared with propofol combined with remifentanil,maintenance anesthesia with sevoflurane combined with remifentanil in patients undergoing laparoscopic total hysterectomy can improve the quality of awakening,reduce the stress response,and induce the recovery of cognitive function with fewer adverse effects.