异丙酚与舒芬太尼静脉复合麻醉对宫腔镜手术患者苏醒质量及炎症反应的影响

Influence of the intravenous anesthesia of propofol combined with sufentanil of patients with hysteroscopic surgery on their recovery quality and inflammatory response

目的:探讨宫腔镜手术应用异丙酚与舒芬太尼静脉复合麻醉的临床效果。方法:选取2023年1-12月本院宫行腔镜手术患者125例临床资料,根据所选麻醉方案的不同分为两组,对照组(65例)采取异丙酚复合瑞芬太尼麻醉,观察组60例采取异丙酚复合舒芬太尼麻醉,对比两组术中血流动力学指标平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2)),苏醒质量、炎症反应以及不良反应。结果:在麻醉前(T0)两组MAP、HR、SpO_(2)无差异(P>0.05);与T0时相比,两组在宫颈扩张时(T1)、术中(T2)、术毕时(T3)的MAP、HR更低,SpO_(2)更高,且T1、T2、T3时观察组MAP、HR、SpO_(2)高于对照组(均P<0.05)。观察组苏醒时间(10.54±1.27min)短于对照组(13.25±2.28min),术后1 h警觉与镇静量表评分(4.14±0.52分)高于对照组(3.74±0.43分)、视觉模拟评分(2.53±0.65分)低于对照组(2.86±0.74分)(P<0.05)。两组术后C-反应蛋白、肿瘤坏死因子-α、白细胞介素-6均较术前提升,但观察组(9.86±1.62 mg/ml、39.81±12.29 pg/ml、45.71±15.28 pg/ml)低于对照组(18.61±7.69 mg/ml、75.53±25.69 pg/ml、78.51±23.92 pg/ml)(均P<0.05)。两组不良反应发生率(29.2%比23.3%)无差异(P>0.05)。结论:异丙酚复合舒芬太尼静脉麻醉方案应用于宫腔镜手术效果显著,能减小患者术中血流动力学波动,提高患者苏醒质量,减轻术后炎症反应,安全性良好。

Objective:To investigate the clinical effect of the intravenous anesthesia of propofol combined with sufentanil of patients during hysteroscopic surgery.Methods:The clinical data of 125 patients with hysteroscopic surgery in the hospital from January 2023 to December 2023 were selected.These patients were divided into two groups according to the different anesthesia regimens.65 patients in the control group were anesthetized with propofol combined with remifentanil,whereas 60 patients in the experimental group were anesthetized with propofol and sufentanil.The values of the intraoperative hemodynamic indexes,such as mean arterial pressure(MAP),heart rate(HR)and blood oxygen saturation(SpO_(2)),the recovery quality,the inflammatory response and the adverse reactions of the patients were compared between groups.Results:There were no significant differences in the values of MAP,HR and SpO_(2)of the patients before anesthesia(T0)between the two groups(P>0.05).Compared with those of the patients in the two groups at T0,the values of MAP and HR at the time of cervical dilatation(T1),during the surgery(T2)and at the end of the surgery(T3)were significantly lower and the SpO_(2)value was significantly higher.The values of MAP,HR and SpO_(2)of the patients in the experimental group at T1,T2and T3were significantly higher than those of the patients in the control group(all P<0.05).The recovery time(10.54±1.27min)of the patients in the experimental group was significantly shorter than that(13.25±2.28min)of the patients in the control group.The score of vigilance and sedation scale(4.14±0.52points)of the patients in the experimental group was significantly higher than that(3.74±0.43points)of the patients in the control group,and the visual analogue scale score(2.53±0.65points)of the patients in the experimental group at 1hour after surgery was significantly lower than that(2.86±0.74points)in the control group(P<0.05).The levels of C-reactive protein,tumor necrosis factor-α and interleukin-6 of the patients in the two groups after operation had increased significantly,and which(9.86±1.62mg/ml,39.81±12.29pg/ml,and 45.71±15.28pg/ml)of the patients in the experimental group were significantly lower than those(18.61±7.69mg/ml,75.53±25.69pg/ml and 78.51±23.92pg/ml)of the patients in the control group(all P<0.05).There was no significant difference in the incidence of the adverse reactions(29.2%vs.23.3%)of the patients between the two groups(P>0.05).Conclusion:The intravenous anesthesia of propofol combined with sufentanil of the patients during hysteroscopic surgery has significant effect,which can reduce the intraoperative hemodynamic fluctuations,enhance the recovery quality and relieve the postoperative inflammatory response of the patients,and with the good safety.