环泊酚联合瑞芬太尼在腔镜胃癌根治术麻醉中的有效性与安全性

Effectiveness and Safety Analysis of Cyclopol Combined with Remifentanil in Anesthesia for Endoscopic Gastric Cancer Radical Surgery

目的 探讨环泊酚联合瑞芬太尼在腔镜胃癌根治术麻醉中的有效性与安全性。方法 将2022年8月至2023年7月在中国人民解放军联勤保障部队第九〇〇医院收治的100例腔镜胃癌根治术患者随机分成丙泊酚联合瑞芬太尼组与环泊酚联合瑞芬太尼组,丙泊酚联合瑞芬太尼组50例予以丙泊酚联合瑞芬太尼麻醉,环泊酚联合瑞芬太尼组50例予以环泊酚联合瑞芬太尼麻醉,比较2组的生命体征(呼吸频率、心率、血氧饱和度)、麻醉指标(麻醉起效时间、自主呼吸恢复时间、苏醒时间、离室时间)、麻醉效果以及不良反应(注射痛、低血压、低氧血症、呼吸抑制、头晕、嗜睡)。结果 呼吸频率在2组间、时点间、组间·时点间的交互作用,差异无统计学意义(P> 0.05);心率、血氧饱和度在2组间、时点间、组间·时点间的交互作用,差异有统计学意义(P <0.05);2组T0-T5的呼吸频率比较,差异无统计学意义(P> 0.05);环泊酚联合瑞芬太尼组T1、T2的心率高于丙泊酚联合瑞芬太尼组,差异有统计学意义(P <0.05),2组其他时间的心率比较,差异无统计学意义(P> 0.05);环泊酚联合瑞芬太尼组T2的血氧饱和度高于丙泊酚联合瑞芬太尼组,差异有统计学意义(P <0.05),2组其他时间的血氧饱和度比较,差异无统计学意义(P> 0.05)。2组麻醉起效时间比较,差异无统计学意义(P>0.05);环泊酚联合瑞芬太尼组自主呼吸恢复时间、苏醒时间、离室时间短于丙泊酚联合瑞芬太尼组,差异有统计学意义(P <0.05)。环泊酚联合瑞芬太尼组总有效率为96.00%,高于丙泊酚联合瑞芬太尼组的84.00%,差异有统计学意义(P <0.05)。环泊酚联合瑞芬太尼组不良反应发生率为10.00%,低于丙泊酚联合瑞芬太尼组的28.00%,差异有统计学意义(P <0.05)。结论 环泊酚联合瑞芬太尼在腔镜胃癌根治术麻醉中的应用效果较好,能够稳定患者术中生命体征,改善麻醉指标,减少不良反应,可推行。

Objective To investigate the effectiveness and safety of cyclophenol combined with remifentanil in anesthesia for laparoscopic radical gastrectomy for gastric cancer.Methods A total of 100 patients who underwent laparoscopic radical gastrectomy for gastric cancer admitted to 900 Hospital of the Joint Logistic Support Force from August 2022 to July 2023 were randomly divided into two groups:the propofol combined with remifentanil group(50 cases) received propofol combined with remifentanil anesthesia,and the cyclopol combined with remifentanil group( 50 cases) received cyclophenol combined with remifentanil anesthesia.The vital signs(respiratory rate,heart rate,and blood oxygen saturation) of the two groups of patients were observed.Anesthesia indicators(onset time of anesthesia,recovery time of spontaneous breathing,awakening time,time of leaving the room),anesthesia effect,and adverse reactions(Injection pain,hypotension,hypoxemia,respiratory depression,dizziness,drowsiness) were also observed.Results The interaction effect of respiratory rate between two groups,time points,and between groups/time points showed no statistically significant difference( P > 0.05);The interaction between heart rate and blood oxygen saturation between two groups,time points,and between groups and time points showed statistically significant differences(P < 0.05).There was no statistically significant difference(P > 0.05) in the respiratory rate between the two groups of T0 to T5.The heart rate of T1 and T2 in the combination of propofol and remifentanil group was higher than that in the combination of propofol and remifentanil group,and the difference was statistically significant(P < 0.05).There was no statistically significant difference in heart rate between the two groups at other times(P > 0.05).The blood oxygen saturation of T2 in the combination of propofol and remifentanil group was higher than that in the combination of propofol and remifentanil group,and the difference was statistically significant(P < 0.05).There was no statistically significant difference in blood oxygen saturation between the two groups at other times(P > 0.05).There was no statistically significant difference in the onset time of anesthesia between the two groups(P > 0.05).The spontaneous breathing recovery time,awakening time,and departure time of the group treated with propofol combined with remifentanil were shorter than those of the group treated with propofol combined with remifentanil,and the differences were statistically significant(P < 0.05).The total effective rate of the combination of propofol and remifentanil group was 96.00%,which was higher than the84.00% of the combination of propofol and remifentanil group,and the difference was statistically significant(P <0.05).The incidence of adverse reactions in the combination of propofol and remifentanil group was 10.00%,which was lower than the 28.00% in the combination of propofol and remifentanil group,and the difference was statistically significant(P < 0.05).Conclusion The application of cyclophorol combined with remifentanil in anesthesia for laparoscopic radical gastrectomy for gastric cancer has a good effect,can stabilize the patient's intraoperative vital signs,improve anesthesia indicators,reduce adverse reactions,and can be promoted.