瑞芬太尼复合七氟醚或丙泊酚对鼻内镜手术患者血流动力学及血糖的影响

Effects of Remifentanil Combined with Sevoflurane or Propofol on Hemodynamics and Blood Glucose in Patients Undergoing Nasal Endoscopic Surgery

目的:探究鼻内镜手术中应用瑞芬太尼复合七氟醚或丙泊酚对患者血流动力学及血糖的影响。方法:选取上海市杨浦区中心医院2021年2月—2023年2月收治的拟行鼻内镜手术患者82例为研究对象,采用盲摸双色球法均分为参照组与试验组,各41例。参照组行瑞芬太尼复合丙泊酚麻醉,试验组行瑞芬太尼复合七氟醚麻醉。比较两组不同时间血流动力学及血糖水平。结果:两组麻醉前、麻醉实施后5 min、麻醉实施后30 min、手术结束后20 min的心肌耗氧量及血糖水平对比,差异无统计学意义(P>0.05);麻醉前,两组心率、平均动脉压对比,差异无统计学意义(P>0.05);试验组麻醉实施后5 min、麻醉实施后30 min、手术结束后20 min的心率及平均动脉压均高于参照组(P<0.05)。结论:相比瑞芬太尼复合丙泊酚,瑞芬太尼复合七氟醚麻醉在鼻内镜手术患者中的应用效果更优,可有效稳定患者血流动力学,且对血糖的影响较小。

Objective:To investigate the effects of the application of remifentanil combined with sevoflurane or propofol on patients'hemodynamics and blood glucose in nasal endoscopic surgery.Methods:Eighty-two patients admitted to Shanghai Yangpu District Central Hospital from February 2021 to February 2023 who were to undergo nasal endoscopic surgery were selected as the study subjects,and were divided into the reference group and the experimental group,each with forty-one cases,by using the blinded bicolor balloon method.The reference group was anesthetized with remifentanil and propofol,and the experimental group was anesthetized with remifentanil and sevoflurane.The hemodynamics and blood glucose level of the two groups were compared at different times.Results:Comparison of myocardial oxygen consumption and blood glucose level between the two groups before anesthesia,5 min after anesthesia implementation,30 min after anesthesia implementation,and 20 min after the end of the operation,the difference was not statistically significant(P>0.05);before anesthesia,comparison of heart rate and mean arterial pressure between the two groups,the difference was not statistically significant(P>0.05);the heart rate and mean arterial pressure of the experimental group were higher than those of the reference group 5 min after anesthesia implementation,30 min after anesthesia implementation,and 20 min after the end of surgery(P<0.05).Conclusion:Compared with remifentanil compounded with propofol,remifentanil compounded with sevoflurane anesthesia has a better application in patients with nasal endoscopic surgery,which can effectively stabilize the hemodynamics of the patients and has less effect on blood glucose.