丙泊酚靶控输注复合阿芬太尼对声带息肉摘除术患者的麻醉效果和血流动力学的影响分析

Analysis of the effects of propofol target-controlled infusion combined with alfentanil on the anesthetic effect and hemodynamics of patients undergoing vocal polypectomy

目的 探讨丙泊酚靶控输注复合阿芬太尼用于声带息肉摘除手术中的安全性和临床效果。方法 选取在赣州市人民医院2023年1月至2024年1月接受声带息肉摘除手术的患者共80例,采用随机数字表法将其分为A组(40例)和F组(40例)。两组患者均采用全身麻醉插管的方式,麻醉诱导开始时设置丙泊酚的血浆靶浓度为3.5μg/ml,缓慢静脉注射罗库溴铵0.6mg/kg后,F组采用芬太尼3μg/kg静脉注射,A组采用阿芬太尼20μg/kg静脉注射。待两组患者肌肉松弛后施行气管插管。记录患者在围术期各个阶段的血流动力学变化情况,记录手术完成时间、苏醒拔管时间和不良反应发生情况。结果 两组间T_(0)~T_(4)时平均动脉压(mean arterial pressure,MAP)和心率(heart rate,HR)比较,差异均无统计学意义(P>0.05);相较于术前基线(T_(0)),两组的MAP和HR在组内T_(1)、T_(2)、T_(3)和T_(4)各时间点均降低(P<0.05),两组组内时间点及交互作用比较,差异有统计学意义(P<0.05)。A组的苏醒拔管时间短于F组(P<0.05)。A组的丙泊酚用量及不良反应事件均少于F组(P<0.05)。结论 在声带息肉摘除术中,相较于使用芬太尼,丙泊酚靶控输注复合阿芬太尼可确保患者循环功能状态稳定,缩短患者术后苏醒时间,降低不良反应发生率。

Objective To assess the safety and therapeutic impact of propofol target-controlled infusion combined with alfentanil for vocal polyp excision.Methods From January 2023 to January 2024,vocal polyp ectomy removal surgery patients 80 cases in Ganzhou People’s Hospital’s were selected and randomly assigned into group A(40 cases)and group F(40 cases).In the anesthetic induction sequence,the two subject groups in the clinical trial had their propofol plasma target concentration set at 3.5μg/ml.Rocuronium bromide was administered at a dosage of 0.6mg/kg,followed by a slow and careful injection.In group F,this was succeeded by an injection of fentanyl at 3μg/kg.In contrast,group A received an intravenous injection of alfentanil at a dosage of 20μg/kg.In both groups,tracheal intubation was executed when muscle relaxation had been achieved.Monitoring and documentation of hemodynamic fluctuations during the perioperative stages.Records were kept for the procedure’s conclusion time,the time frame for regaining consciousness and extubation,and any adverse effects experienced.Results While the contrast of mean arterial pressure(MAP)and heart rate(HR)between two groups at each time point from T_(0) to T_(4) were statistically non-significant(P>0.05).Compared with preoperative baseline(T_(0)),MAP and HR were lower in both groups at all time points within group at T_(1),T_(2),T_(3) and T_(4)(P<0.05),the within-group examination of these parameters across time points and their interactions did show quantifiable differences(P<0.05).The interval from regaining consciousness to extubation was shorter in group A than that in group F(P<0.05).Additionally,the quantity of propofol and the number of unanticipated effects were diminished in group A than those in group F(P<0.05).Conclusion In the context of vocal polypectemy,the administration of propofol via a targeted infusion combined with alfentanil maintains hemodynamic stability,minimizes propofol dosing in contrast to fentanyl,and is linked to faster awakening times and a lower occurrence of adverse effects.