丙泊酚靶控输注复合瑞芬太尼麻醉在超低位直肠癌患者麻醉中的应用

Application of propofol target controlled infusion combined with remifentanil anesthesia in anesthesia of patients with ultra-low rectal cancer

目的比较丙泊酚靶控输注复合瑞芬太尼麻醉与静吸复合麻醉在超低位直肠癌患者麻醉中的应用效果。方法选取我院2019年10月至2023年5月收治的82例超低位直肠癌患者为研究对象,以麻醉差异将其分为常规组(41例,静吸复合麻醉)和观察组(41例,丙泊酚靶控输注复合瑞芬太尼麻醉)。比较两组的麻醉效果。结果入室时(T0),两组的心率(HR)、血氧饱和度(SpO2)比较,差异无统计学意义(P>0.05);插管时(T1)至拔管时(T4),观察组的HR显著低于常规组,SpO2显著高于常规组(P<0.05);观察组手术过程中HR、SpO2的波动幅度小于常规组。T0,两组的平均动脉压(MAP)、中心静脉压(CVP)、平均肺动脉压(MPAP)比较,差异无统计学意义(P>0.05);T1~T4,观察组的MAP、CVP均显著低于常规组,MPAP显著高于常规组(P<0.05);观察组麻醉过程中MAP、CVP、MPAP的波动幅度小于常规组。观察组的术中呼吸循环抑制总发生率及术后不良反应总发生率均显著低于常规组(P<0.05)。结论相较于静吸复合麻醉,丙泊酚靶控输注复合瑞芬太尼麻醉在超低位直肠癌患者麻醉中具有更显著的应用效果。

Objective To compare the application effects of propofol target controlled infusion combined with remifentanil anesthesia and combined anesthesia of intravenous and inhalation in anesthesia of patients with ultra-low rectal cancer.Methods A total of 82 patients with ultra-low rectal cancer admitted in our hospital from October 2019 to May 2023 were selected as the research objects.According to the difference of anesthesia,the patients were divided into conventional group(41 cases,combined anesthesia of intravenous and inhalation)and observation group(41 cases,propofol target controlled infusion combined with remifentanil anesthesia).The anesthetic effects of the two groups were compared.Results At the time of entering the room(T0),there were no significant differences in heart rate(HR)and oxygen saturation(SpO2)between the two groups(P>0.05);during intubation(T1)to extubation(T4),HR in the observation group was significantly lower than that in the conventional group,and SpO2 was significantly higher than that in the conventional group(P<0.05);the fluctuation range of HR and SpO2 in the observation group were smaller than those in the conventional group.At T0,there were no significant differences in mean artery pressure(MAP),central venous pressure(CVP)and mean pulmonary arterial pressure(MPAP)between the two groups(P>0.05);at T1-T4,MAP and CVP in the observation group were significantly lower than those in the conventional group,and MPAP was significantly higher than that in the conventional group(P<0.05);the fluctuation range of MAP,CVP and MPAP during anesthesia in the observation group were smaller than those in the conventional group.The total incidences of intraoperative respiratory and circulatory inhibition and postoperative adverse reactions in the observation group were significantly lower than those in the conventional group(P<0.05).Conclusion Compared with combined anesthesia of intravenous and inhalation,propofol target-controlled infusion combined with remifentanil anesthesia has a more significant application effect in anesthesia of patients with ultra-low rectal cancer.