去阿片全身麻醉策略在输尿管软镜钬激光碎石术中的应用效果

Application Effect of Opioid-Free General Anesthesia Strategy in Ureteroscopic Holmium Laser Lithotripsy

目的:探究去阿片全身麻醉策略在输尿管软镜钬激光碎石术中的应用效果。方法:选取2023年1-12月于锦屏县人民医院行输尿管软镜钬激光碎石术的100例肾结石及输尿管结石患者作为研究对象,随机分为试验组和对照组,各50例。对照组使用常规全身麻醉方案,试验组使用去阿片全身麻醉策略。比较两组麻醉效果。结果:麻醉诱导前10 min(T_(0))、意识消失时(T_(1))、手术开始时(T_(3))、手术结束时(T_(4))、喉罩拔出时(T_(5)),两组平均动脉压(MAP)、脑电双频指数(BIS)比较,差异无统计学意义(P>0.05);置入喉罩时(T_(2)),试验组MAP、BIS高于对照组,差异有统计学意义(P<0.001)。T_(0)、T_(1)、T_(2)、T_(3)、T_(5),两组心率(HR)比较,差异无统计学意义(P>0.05);T_(4),试验组HR高于对照组,差异有统计学意义(P<0.001)。两组麻醉诱导期间丙泊酚使用剂量比较,差异无统计学意义(P>0.05);试验组丙泊酚总使用剂量小于对照组,差异有统计学意义(P<0.001)。两组自主呼吸恢复时间、苏醒时间、喉罩拔出时间以及出手术室后疼痛评分、Ramsay评分比较,差异无统计学意义(P>0.05)。结论:去阿片全身麻醉策略在输尿管软镜钬激光碎石术中的应用效果较好,麻醉效果与常规全身麻醉方案相当,且能减少丙泊酚使用剂量。

Objective:To explore the application effect of opioid-free general anesthesia strategy in ureteroscopic holmium laser lithotripsy.Methods:A total of 100 patients with renal calculus who underwent ureteroscopic holmium laser lithotripsy in People's Hospital of Jinping County from January 2023 to December 2023 were selected as the study subjects.They were randomly divided into an experimental group and a control group with 50 patients in each group.The control group adopted conventional general anesthesia strategy and the experimental group adopted opioid-free general anesthesia strategy.The anesthesia effects of the two groups were compared.Results:There was no significant difference in mean arterial pressure(MAP)and bispectral index(BIS)between the two groups at 10 min before anesthesia induction(T_(0)),upon loss of consciousness(T_(1)),at the beginning of surgery(T_(3)),at the end of surgery(T_(4)),and upon laryngeal mask withdrawal(T_(5))(P>0.05).Upon laryngeal mask insertion(T_(2)),the MAP and BIS in the experimental group were higher than those in the control group,and the difference was statistically significant(P<0.001).There was no significant difference in HR between the two groups at T_(0),T_(1),T_(2),T_(3) and T5(P>0.05).At T4,the HR in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.001).There was no significant difference in the dose of propofol during anesthesia induction between the two groups(P>0.05).The total dose of propofol in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.001).There were no significant differences in spontaneous breathing recovery time,awakening time,laryngeal mask withdrawal time,pain score and Ramsay score after leaving the operating room between the two groups(P>0.05).Conclusion:The application of opioid-free general anesthesia strategy in ureteroscopic holmium laser lithotripsy has better effects,its anesthesia effects are comparable to that of conventional general anesthesia strategy,and it can reduce the dose of propofol.