七氟烷吸入复合静脉全身麻醉在口腔癌根治手术患者中的应用效果

Effects of Sevoflurane inhalation combined with intravenous general anesthesia in patients undergoing radical surgery for oral cancer

目的:观察七氟烷吸入复合静脉全身麻醉在口腔癌根治手术患者中的应用效果。方法:选取2021年7月至2023年7月该院收治的80例口腔癌患者进行前瞻性研究,按照随机数字表法将其分为研究组与对照组各40例。两组均采用静脉麻醉诱导,对照组采用丙泊酚复合瑞芬太尼进行麻醉维持,研究组采用七氟烷复合静脉全身麻醉进行麻醉维持。比较两组术中不同时间血流动力学指标水平、术中静脉麻醉药物(丙泊酚、瑞芬太尼)用量、苏醒期指标(苏醒时间、自主呼吸恢复时间和拔管时间)水平、手术前后应激指标[皮质醇(Cor)、去甲肾上腺素(NE)]水平及不良反应发生率。结果:两组平均动脉压、心率水平在麻醉诱导后均下降,在插管、拔管时均升高,但研究组插管时、拔管时的平均动脉压、心率水平均低于对照组,差异有统计学意义(P<0.05);研究组术中丙泊酚、瑞芬太尼用量均少于对照组,差异有统计学意义(P<0.05);研究组苏醒时间、自主呼吸恢复时间和拔管时间均短于对照组,差异有统计学意义(P<0.05);术后1 d,两组血清Cor、NE水平均高于术前,但研究组低于对照组,差异有统计学意义(P<0.05);研究组不良反应发生率为7.50%(3/40),低于对照组的25.00%(10/40),差异有统计学意义(P<0.05)。结论:与全凭静脉麻醉相比,七氟烷吸入复合静脉全身麻醉用于口腔癌根治手术患者效果良好,有利于维持血流动力学稳定,减轻应激反应,减少静脉麻醉药物用量,加快患者术后苏醒,且安全性高。

Objective:To observe application effects of Sevoflurane inhalation combined with intravenous general anesthesia in patients undergoing radical surgery for oral cancer.Methods:A prospective study was conducted on 80 patients with oral cancer admitted to the hospital from July 2021 to July 2023.According to the random number table method,they were divided into study group and control group,40 cases in each group.Both groups were induced by intravenous anesthesia.The control group was given Propofol combined with Remifentanil for anesthesia maintenance,while the study group was given Sevoflurane combined with intravenous anesthesia for anesthesia maintenance.The levels of hemodynamic indexes at different time during the operation,the dosage of intravenous anesthetics(Propofol and Remifentanil)during the operation,the levels of recovery period indexes(recovery time,spontaneous breathing recovery time and extubation time)and stress indexes[cortisol(Cor),norepinephrine(NE)]before and after the surgery,and the incidence of adverse reactions were compared between the two groups.Results:The levels of mean arterial pressure and heart rate of the two groups decreased after anesthesia induction,and increased during intubation and extubation.However,the mean arterial pressure and heart rate during intubation and extubation in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The dosage of Propofol and Remifentanil in the study group was less than that in the control group,and the difference was statistically significant(P<0.05).The recovery time,the spontaneous breathing recovery time and the extubation time of the study group were shorter than those of the control group,and the differences were statistically significant(P<0.05).1 day after the surgery,the levels of serum Cor and NE in the two groups were higher than those before the surgery,but those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of adverse reactions in the study group was 7.50%(3/40),which was lower than 25.00%(10/40)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Compared with total intravenous anesthesia,Sevoflurane inhalation combined with intravenous general anesthesia is effective in the patients undergoing radical surgery for oral cancer.It is beneficial to maintain the hemodynamic stability,inhibit the stress response,reduce the dosage of intravenous anesthetics,accelerate the postoperative recovery,and has high safety.