喉罩通气联合舒芬太尼复合右美托咪定麻醉对腹腔镜子宫切除术患者的影响

Effect of laryngeal mask ventilation combined with sufentanil compound dexmedetomidine anesthesia in patients undergoing laparoscopic hysterectomy

目的探究喉罩通气联合舒芬太尼复合右美托咪定麻醉对腹腔镜子宫切除术患者的影响。方法将2019年7月~2022年12月在我院拟行腹腔镜子宫切除术的80例患者作为研究对象,采用信封法分组,分为对照组和观察组,每组40例患者。对照组患者采用气管插管联合舒芬太尼复合右美托咪定麻醉,观察组采用喉罩通气联合舒芬太尼复合右美托咪定麻醉,比较患者手术情况包括:苏醒时间、追加肌松药物情况、患者术中心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP),对患者术前及术后不同时间(30 min、12 h、24 h)的血气情况进行分析,比较患者术后并发症。结果观察组的苏醒时间显著短于对照组,术中发生追加肌松的情况少于对照组,MAP及HR低于对照组,两组间比较差异有统计学意义(t苏醒时间=4.583,χ^(2)追加肌松=4.713,t_(MAP)=7.087,t_(HR)=3.066,P<0.05)。术后30 min观察组的pH高于对照组(t_(30min)=-2.058,P<0.05),术前、术后12 h及术后24 h两组间PH比较差异无统计学意义(P>0.05);术前、术后30 min、术后12 h及术后24 h两组间PaO_(2)水平组间差异无统计学意义(P>0.05);术前、术后30 min、术后12 h两组间PaCO_(2)水平组间无差异(P>0.05),术后24 h时观察组PaCO_(2)水平低于对照组(t24 h=2.582,P<0.05)。观察组并发症发生率为7.50%,低于对照组(25.00%),差异有统计学意义(χ^(2)总发生率=4.501,P<0.05)。结论对腹腔镜子宫切除术患者行喉罩通气联合舒芬太尼复合右美托咪定麻醉具有较好的安全性,可以缩短患者术后苏醒时间,维持患者血气指标正常,具有较高的临床应用价值。

Objective To explore the effects of laryngeal mask ventilation combined with sufentanyl and compound dexmedetomidine anesthesia in patients undergoing laparoscopic hysterectomy.Methods Eighty patients who proposed laparoscopic hysterectomy in our hospital from July 2019 to December 2022 were divided into control group and observation group using the envelope method,with 40 patients in each group.The control group used trached intubation combined with dexmedetomidine anesthesia,the observation group used laryngeal mask ventila-tion combined with sufentanil compound dexmedetomidine anesthesia,the surgical conditions included recovery time,additional muscle relaxation,heart rate(HR)during surgery,mean arterial pressure were compared,the blood gas status preoperative and postoperative time(30 min,12 h,24 h)were analyzed,and the postoperative complications were compared.Results The wake time of the observation group was significantly shorter than that of control group,less intraoperative additional muscle relaxation than control group,MAP and HR were lower than that of control group,and the difference was statistically significant(twake time=4.583,χ^(2)a dditional muscle relaxation=4.713,t_(MAP)=7.087,t_(HR)=3.066,P<0.05).30 min after surgery,pH in the observation group was higher than that in control group(t_(30 min)=-2.058,P<0.05),there was no difference in pH between the two groups preoperatively,at 12 hours postoperatively,and at 24 hours postoperatively(P>0.05);There was no difference in PaO_(2)levels between the two groups preoperatively,at 30 minutes postoperatively,at 12 hours postoperatively,and at 24 hours postoperatively(P>0.05);There was no difference in PaCO_(2)levels between the two groups preoperatively,at 30 minutes postoperatively,and at 12 hours postoperatively(P>0.05),the level of PaCO_(2)in observation group was lower than that in the control group at 24 hours post-operation(t24 h=2.582,P<0.05).The incidence of complications in the observation group was 7.50%,lower than the control group(25.00%),and the difference was significant(χ2o verall incidence=4.501,P<0.05).Conclusion The laryngeal mask ventilation combined with sufentanil compound dexmedetomidine anesthesia for patients undergoing laparoscopic hysterectomy demonstrates good safty,and can reduce the postoperative recovery time,maintain the normal blood gas index,and have high clinical application value.