Effects of Total Intravenous Anesthesia and Static Aspiration Combined General Anesthesia on Postoperative Cognitive Function and Psychological State of Elderly Patients with Esophageal Cancer

Objective: To compare the effects of total intravenous anesthesia and static aspiration combined general anesthesia on postoperative cognitive function and psychological state of elderly esophageal cancer patients. Methods: From July 2020 to April 2021, 180 elderly patients who underwent radical esophageal cancer surgery in our hospital were randomly divided into 90 cases in the control group and 90 in the observation group. The control group used static aspiration compound general anesthesia, and the patients in the observation group used intravenous anesthesia to compare the cognitive function and psychological state of the two groups of patients. Results: There was no statistical difference in the cognitive function score of patients in the observation group 30 minutes before anesthesia, 1 h and 24 hours after anesthesia compared with that in the control group, P > 0.05;there was no statistical difference between the Hamilton Anxiety Scale (HAMA) scores 30 minutes before and 24 hours after anesthesia in the observation group compared with the control group, P > 0.05;the cognitive function score of patients in the observation group of 4 h after surgery and 12 h after operation was significantly higher than that of the control group;the HAMA scores of patients in the observation group of 1 h, 4 h and 12 h after surgery were significantly lower than that of the control group, P Conclusion: The application of total intravenous anesthesia in elderly patients with esophageal cancer surgery can reduce the impact of anesthesia on their cognitive function and psychological state, which is worth popularizing and applying in clinical practice.

Effect of epidural block combined intravenous general anesthesia stress on the stress response and T lymphocyte subsets in patients with breast cancer undergoing radical mastectomy

Objective: To investigate the effect of epidural block combined with intravenous anesthesia on stress response and T lymphocyte subsets in patients with breast cancer undergoing radical mastectomy. Methods: In our hospital from July 2016 to June 2017 undergoing radical mastectomy for breast cancer of 88 patients were randomly divided into observation group and control group of 44 cases, 2 patients underwent routine preoperative preparation, and routine blood pressure, heart rate, pulse, oxygen saturation, ECG monitoring, control group with intravenous anesthesia. The observation group was treated with epidural block combined with intravenous anesthesia. 2 groups of patients before anesthesia, 30 MIM (T0), 1 h after skin incision (T1), 4 h after operation (T2), 24 h after operation (T3), 48 h after operation (T4) from peripheral venous blood were measured by interleukin-8 (IL-8) and interferon gamma (IFN-γ), cortisol (Cor), prolactin (PRL), growth hormone (GH) and T lymphocyte subsets (CD3+, CD4+, CD8+), the calculation of CD4+/CD8+ value. Results: the serum IL-8 level of T1, T2, T3and T4 decreased gradually, were lower than at T0, and the control group at each time point had no significant difference, T1, T2, T3group, T4IL-8 levels lower than the control group;the 2 groups of serum IFN-γ levels T1 and T2had no significant change, T3and T4increased gradually, was higher than that of T0, but no significant difference between the 2 groups of IFN-γ levels. 2 serum Cor levels peaked at T1, decreased at T2, was higher than that of T0, T3, T4returned to T0, the observation group T1, T2Cor level lower than the control group;the serum PRL levels of 2 groups reached a peak at T1, T2, T3at the time of T4decreased gradually, was higher than that of T0, T1, T2, T3of the observation group at the PRL level is lower than the control group;the serum level of GH 2 in group T1increased gradually, reached a peak at T2, T3and T4 decreased gradually, was higher than that of T0, the observation group T1, T2, T3, T4, GH levels lower than the control group. 2 groups of CD3+ decreased gradually in T1, T2, were lower than T0, T3, T4returned to T0, the observation group T1, T2CD3+ was higher than the control group;group CD4+ decreased gradually in T1, T2, T3and T4were lower than control, T0when, and the observation group CD4+ in T1, T2, T3, T4, no significant changes were observed in group T1, T2, T3, T4and CD4+ higher than that of the control group;the 2 group CD8+ had no obvious changes in T1, T2, T3, T4;observation group CD4+/CD8+ decreased gradually in T1, T2, were lower than T0, T3, T4returned to T0, the observation group T1, T2CD4+/CD8+ was higher than the control group. Conclusion: epidural block combined with intravenous anesthesia for breast cancer radical mastectomy can effectively relieve the stress and inflammatory reaction, alleviate the immunosuppression, and help to restore the postoperative immune function.

Effects of intravenous inhalational anesthesia on the hemodynamic homeostasis as well as postoperative brain function and Th1/Th2 immunity in elderly patients with femoral neck fracture

Objective: To explore the effects of intravenous inhalational anesthesia on the hemodynamic homeostasis as well as postoperative brain function and Th1/Th2 immunity in elderly patients with femoral neck fracture. Methods: A total of 176 elderly patients with femoral neck fracture who received hip replacement in our hospital between July 2016 and June 2017 were divided into the total intravenous anesthesia group (n=86) and the intravenous inhalational anesthesia group (n=90) according to the anesthesia solution. The differences in introperative hemodynamic parameter levels as well as postoperative brain function index and Th1/Th2 cytokine contents were compared between the two groups. Results: During operation, hemodynamic parameters MAP and HR levels in intravenous inhalational anesthesia group were lower than those in total intravenous anesthesia group. 24 h after operation, serum brain function indexes MBP, S100B and NSE contents in intravenous inhalational anesthesia group were lower than those in total intravenous anesthesia group;serum Th1 cytokines IFN-γand IL-2 contents were higher than those in total intravenous anaesthesia group whereas Th2 cytokines IL-4 and IL-13 contents were lower than those in total intravenous anesthesia group. Conclusion: The intravenous inhalational anesthesia can effectively stabilize the intraoperative hemodynamics and reduce the postoperative brain function and Th1/Th2 immune function injury in elderly patients with femoral neck fracture.

Effect of intravenous inhalational anesthesia under Narcotrend monitor on the systemic traumatic reaction after laparoscopic cholecystectomy

Objective:To study the effect of intravenous inhalational anesthesia under Narcotrend monitor on the systemic traumatic reaction after laparoscopic cholecystectomy.Methods:A total of 116 patients with gallstone who received laparoscopic surgery in our hospital between July 2012 and April 2016 were collected and divided into the combined anesthesia group (n=65) who accepted intravenous inhalational anesthesia under Narcotrend monitor and the intravenous anesthesia group (n=51) who accepted total intravenous anesthesia after the anesthesia methods and relevant test results were reviewed. 1 d after operation, enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of pain mediators and inflammation mediators;automatic biochemical analyzer was used to detect the levels of oxidative stress indexes.Results:1 d after operation, serum pain mediators 5-HT, PGE2, NO and HT levels of observation group were lower than those of control group;serum oxidation indexes AOPPs and LHP levels of observation group were lower than those of control group while anti-oxidation indexes CAT and GSH-Px levels were higher than those of control group;serum pro-inflammatory factors IL-6, IL-8 and CRP levels of observation group were lower than those of control group while anti-inflammatory factors IL-4, IL-10 and IL-13 levels were higher than those of control group.Conclusion:Intravenous inhalational anesthesia under Narcotrend monitor can reduce the postoperative systemic traumatic reaction degree in patients with laparoscopic cholecystectomy.

Differences in the effects of intravenous inhalational anesthesia and total intravenous anesthesia on the systemic traumatic response after laparoscopic cholecystectomy

Objective: To study the effect of intravenous inhalational anesthesia under monitoring on systemic traumatic response after laparoscopic cholecystectomy. Methods: A total of 80 cases of patients with chronic cholecystitis who received laparoscopic cholecystectomy in our hospital between June 2016 and October 2016 were collected and divided into the control group who accepted total intravenous anesthesia and the observation group who accepted intravenous inhalational anesthesia after the anesthesia methods were reviewed. 6 h, 12 h and 24 h after operation, the RIA method was adopted to determine the serum contents of pain mediators, enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of inflammatory factors and stress hormones, and auto-coagulation analyzer was used to detect the plasma contents of coagulation function indexes. Results: 6 h, 12 h and 24 h after operation, serum pain mediators 5-HT, β-EP and NPY levels of observation group were lower than those of control group, inflammatory factors hs-CRP, IL-6, IL-8 and TNF-α levels were lower than those of control group, and stress hormones Cor, ALD and NE levels were lower than those of control group;plasma coagulation function indexes TXB2, D-D and PLT levels of observation group were lower than those of control group. Conclusion: Intravenous inhalational anesthesia under monitoring can reduce the systemic traumatic reaction after laparoscopic cholecystectomy and has positive clinical significance.

The anesthesia for selective posterior rhizotomy at lumbar and sacral regions on juvenile cerebral palsy patients

Objective To summarize the anesthesia techniques performed in the selective posterior rhizotomy(SPR) at lumbar and sacral regions(L&R)on juvenile cerebral palsy(CP) patients. Method 144 CP patients below 10 years were successfully performed SPR at L&R under combined intravenous and inhalation anesthesia (CIIA) in prone position with threshold values of each nerve root being measured by means of nerve root electric stimulus (NRES). Result All patients were performed SPR and NRES successfully although blood pressure and heart rate increased significantly while NRES. Conclusion CIIA is safe and effective for juvenile CP patients to be performed SPR at L&R.

全身麻醉药对围手术期冠心病患者的风险及其防范的研究进展

全身麻醉药对冠心病患者的副作用受到越来越多临床医师的关注,现就冠心病患者病理生理特点、全身麻醉药的作用机制及其在围手术期冠心病患者中的使用风险、风险的预防与控制以及麻醉风险的预防措施等做一综述,对于提高围手术期冠心病患者麻醉风险的预防和控制具有重要的临床意义。

静吸复合麻醉和全凭静脉麻醉在腹腔镜胆囊手术中的麻醉效果研究

目的研究静吸复合麻醉和全凭静脉麻醉在腹腔镜胆囊手术中的麻醉效果。方法112例腹腔镜胆囊手术患者,以信封随机抽取法分为对照组和观察组,每组56例。对照组患者术中开展静吸复合麻醉,观察组患者术中开展全凭静脉麻醉。比较两组麻醉指标(麻醉拔管时间、苏醒时间、定向力恢复时间)、应激指标[去甲肾上腺素(NE)、皮质醇(Cor)]、生理指标[平均动脉压(MAP)、心率]、免疫指标(CD3+、CD4+、CD4+/CD8+)、炎症因子[超敏C反应蛋白(hs-CRP)、白细胞介素-8(IL-8)、白细胞介素-6(IL-6)]、不良反应发生情况。结果观察组麻醉拔管时间、苏醒时间、定向力恢复时间分别为(6.25±0.62)、(5.67±0.13)、(9.19±1.05)min,显著短于对照组的(7.69±0.69)、(6.95±0.22)、(14.36±1.12)min,差异具有统计学意义(P<0.05)。术后,观察组NE、Cor水平分别为(7.47±0.35)、(216.88±3.30)nmol/L,均低于对照组的(9.72±0.59)、(356.13±3.25)nmol/L,差异具有统计学意义(P<0.05)。插管即刻(T1)、手术开始5 min(T2)、拔管即刻(T3)时,观察组心率、MAP均低于对照组,差异具有统计学意义(P<0.05)。术后,观察组CD3+、CD4+、CD4+/CD8+分别为(69.02±1.46)%、(43.79±0.16)%、(1.42±0.12),均高于对照组的(60.62±1.45)%、(39.68±0.18)%、(1.30±0.11),差异具有统计学意义(P<0.05)。术后,观察组hs-CRP、IL-8、IL-6水平分别为(12.74±3.22)mg/L、(22.25±0.22)pg/ml、(13.36±2.14)pg/ml,低于对照组的(19.65±3.24)mg/L、(35.56±0.25)pg/ml、(24.81±2.26)pg/ml,差异具有统计学意义(P<0.05)。观察组不良反应发生率为1.79%,低于对照组的12.50%,差异具有统计学意义(P<0.05)。结论全凭静脉麻醉在腹腔镜胆囊手术中具有积极的应用价值,可以有效提高麻醉效果,稳定患者血流动力学,降低应激反应、炎症反应,减少对免疫功能的影响,值得临床推广。

七氟醚静脉-吸入复合麻醉对合并冠心病的老年腹腔镜手术患者麻醉质量心功能和心血管事件的影响

目的探究七氟醚静脉-吸入复合麻醉对合并冠心病的老年腹腔镜手术患者麻醉质量、心功能和心血管事件的影响。方法回顾性分析浙江省台州医院2020年7月至2023年8月收治的行腹腔镜手术的冠心病患者临床资料,从行丙泊酚麻醉的患者中随机抽取40例纳入对照组,从行七氟醚静脉-吸入复合麻醉的患者中随机抽取40例纳入观察组。比较2组患者麻醉质量(麻醉时间、麻醉满意度、清醒时间、定向恢复时间)差异;记录不同时间点[术前(T0)、手术开始时(T1)、手术进行15 min(T2)、术后(T3)]的生命体征[心率、收缩压(SBP)、舒张压(DBP)];比较T0、T3时的心功能[心排量(CO)、左室射血分数(LVEF)、N末端脑钠肽前体(NT-proBNP)]、心肌酶水平[天冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)]、氧化应激[血清去甲肾上腺素(NE)、皮质醇(Cor)、促肾上腺皮质激素(ACTH)]水平;比较2组患者不良心血管事件发生情况。结果观察组满意度评分均高于对照组(P<0.05),观察组麻醉时间、清醒时间、定向恢复时间均低于对照组(P<0.05);在T0、T3时,2组患者心率、SBP、DBP水平差异无统计学意义(P>0.05),T1、T2时,观察组心率、SBP、DBP水平均高于对照组(P<0.05);T3时,2组患者CO、LVEF水平均较T0时降低,且观察组高于对照组(P<0.05),2组患者NT-proBNP、AST、LDH、CK-MB、NE、Cor、ACTH水平均较T0时升高,且观察组低于对照组(P<0.05);观察组心血管不良事件发生情况低于对照组(P<0.05)。结论七氟醚静脉-吸入复合麻醉在合并冠心病的老年腹腔镜手术患者中具有较高的麻醉质量,能减少对心功能的损伤,且不会增加不良心血管事件的发生风险。

静脉辅助镇静镇痛麻醉联合球后麻醉在玻璃体切除手术的有效性和安全性观察

目的观察单纯球后麻醉与静脉辅助镇静镇痛麻醉联合球后麻醉在玻璃体切除手术中的有效性和安全性。方法前瞻性病例对照研究。在本院进行研究的对象为200名患者,手术治疗时间为2022年2月至2023年6月的玻璃体切除手术。通过随机分组的方式,将200名患者分为对照组和联合组。对照组接受单纯球后麻醉,而联合组则接受静脉辅助镇静镇痛麻醉联合球后麻醉。记录对照组和联合组的实验对象在不同时刻的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))以及镇静评分:入室后静卧10 min为T0、球后麻醉注射操作时为T_(1)、手术进行30 min为T_(2)、结束手术操作时为T_(3)。在T_(1)时点,我们记录了疼痛的发生率,并记录了两组患者在手术过程中出现的不良反应情况。此外,我们还记录了术前30 min和手术结束时的状态焦虑问卷评分(SAI),以及主刀医生和患者的满意度评分。结果在T_(1)、T_(2)和T_(3)时点,联合组的MAP和HR评分均明显低于对照组,同时镇静评分(Ramsay评分)明显高于对照组(均P<0.05)。在各个时点,联合组与对照组的SpO_(2)相比没有统计学意义上的差异。在T_(1)时点,联合组患者的疼痛发生率比对照组下降了39%;手术过程中,对照组和联合组均未出现恶心、呕吐、抑制呼吸等情况;术前30 min时,对照组和联合组的SAI评分差异无统计学意义(P=0.095),但联合组手术后的SAI评分明显低于对照组(P<0.001);手术医生和患者对联合组的满意度评分均高于对照组(P<0.001)。结论在进行玻璃体切除手术时,结合使用静脉辅助镇静镇痛麻醉和球后麻醉,可以更好地保持患者的血流动力学平稳,增加患者的满意度和舒适度,提高手术的安全性。

七氟醚吸入麻醉与静吸复合麻醉在小儿脑瘫手术中的麻醉效果对比研究

目的分析在小儿脑瘫(Cerebral Palsy,CP)手术中应用七氟醚吸入麻醉与静吸复合麻醉的效果。方法选取山东省康复医院于2022年1月—2023年7月收治的90例脑瘫患儿为研究对象,以双盲法分为两组,每组45例,对照组采取七氟醚吸入麻醉,观察组采取静吸复合麻醉,比较两组不良反应、心率和血氧饱和度指标。结果观察组术后寒战总发生率为4.44%,低于对照组的22.22%,差异有统计学意义(P<0.05)。观察组不良反应总发生率为2.22%,低于对照组的20.00%,差异有统计学意义(P<0.05)。气管插管后15 min,两组心率均下降,但观察组的心率优于对照组,差异有统计学意义(P<0.05);观察组患儿的血氧饱和度优于对照组,差异有统计学意义(P<0.05)。结论在小儿脑瘫手术中选取静吸复合麻醉,患儿寒战及不良反应发生率低,且心率和血氧饱和度更优,对保障手术顺利进行有积极作用。

超声引导下双侧腹横肌平面阻滞复合静脉自控镇痛泵在腰-硬联合麻醉剖宫产术后产妇中的应用

目的探讨超声引导下双侧腹横肌平面阻滞复合静脉自控镇痛泵在腰-硬联合麻醉剖宫产术后产妇中的应用效果。方法选取2022年5月至2023年6月在我院接受腰-硬联合麻醉剖宫产手术的104例产妇,根据术后镇痛方式不同分为参照组(51例)和研究组(53例)。参照组术后予以常规腹横肌平面阻滞复合静脉自控镇痛泵进行镇痛,研究组术后予以超声引导下双侧腹横肌平面阻滞复合静脉自控镇痛泵进行镇痛,均持续干预至出院。比较两组产妇术后疼痛程度、镇痛泵按压次数、首次下地活动时间、术后住院时间及不良反应。结果研究组术后6 h、12 h的VAS评分低于参照组(P<0.05)。研究组镇痛泵按压次数少于参照组,首次下地活动时间、住院时间短于参照组(P<0.05)。研究组不良反应发生率为5.66%,低于参照组的19.61%(P<0.05)。结论腰-硬联合麻醉剖宫产术后产妇应用超声引导下双侧腹横肌平面阻滞复合静脉自控镇痛泵的镇痛效果较好,能明显促进产妇术后尽快恢复,减少不良反应的发生。

全凭静脉全身麻醉与静脉复合七氟烷吸入全身麻醉在小儿麻醉中的安全性比较

目的探讨小儿麻醉中实施全凭静脉全身麻醉与静脉复合七氟烷吸入全身麻醉的效果。方法选取2022年9月至2023年9月日照市中医医院收治的60例手术患儿作为研究对象,采用随机数字表法将其分为对照组和观察组,各30例。对照组患儿采用丙泊酚全凭静脉全身麻醉,观察组患儿采用静脉复合七氟烷吸入全身麻醉。比较两组患儿的血流动力学指标、术后苏醒情况、应激反应指标、谵妄发生情况和不良反应发生情况。结果观察组术中的平均动脉压(MAP)、心率(HR)以及术中、术后20 min的血氧饱和度(SpO_(2))高于对照组,差异有统计学意义(P<0.05)。观察组的拔管时间、定向力恢复时间、苏醒时间短于对照组,插管时间、意识消失时间长于对照组,差异有统计学意义(P<0.05)。观察组术后20 min、气管拔管后的血清去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)高于对照组,差异有统计学意义(P<0.05)。观察组术后3 d的儿科麻醉后苏醒期谵妄(PAED)量表评分低于对照组,差异有统计学意义(P<0.05)。观察组的不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论小儿麻醉中实施静脉复合七氟烷吸入全身麻醉方式,可更好地稳定术中血流动力学,术后快速苏醒及恢复,且减少术后谵妄的发生,安全性有保障,但丙泊酚全凭静脉麻醉可减轻围手术期的应激反应。

静吸复合麻醉与表面麻醉用于小儿泪道探通术中的对比研究

目的对比分析静吸复合麻醉与表面麻醉用于小儿泪道探通术中的麻醉效果及安全性。方法选取抚顺市眼病医院2020年1月至2020年12月收治的患有先天性泪道阻塞疾病并开展泪道探通术的患儿96例(105眼)为研究对象,根据选择使用麻醉的方式不同而将这些患儿分为对照组(n=52,57眼)与观察组(n=44,48眼),对照组采用表面麻醉,观察组采用静吸复合麻醉。比较两组血流动力学指标、治愈率及并发症发生情况。结果两组MAP和HR组间、时间、交互效应比较差异有统计学意义(P<0.05),两组SpO2组间、时间和交互效应比较差异无统计学意义。在麻醉诱导前(T0)、意识消失(T1)、手术开始后1min(T3)、手术开始后5min(T4)时,两组MAP、HR比较差异无统计学意义;在手术开始时(T2),观察组MAP和HR均低于对照组,差异有统计学意义(P<0.05)。两组治愈率比较差异无统计学意义。观察组术后溢泪、形成假道发生率均低于对照组差异有统计学意义(P<0.05);两组呛咳、眼眶蜂窝织炎发生率比较差异无统计学意义。结论静吸复合麻醉应用于小儿泪道探通术中,可维持患儿血流动力学稳定,减少术后溢泪、形成假道等并发症发生,在安全方面更有保障。

MASS及WFTSS在腹腔镜胆囊切除患者ERAS中的比较研究

目的对改良的Aldrete评分系统(modified Aldrete scoring system,MASS)及White快速通道评分系统(White’s fast-track scoring system,WFTSS)在术后快速康复(enhanced recovery after surgery,ERAS)方面做出评价,比较七氟醚与丙泊酚维持麻醉对ERAS的影响。方法选取2021年1月至2023年10月于宁波大学附属第一医院接受腹腔镜胆囊切除手术的患者160例作为研究对象,采用随机数字表法将患者分为七氟醚组和丙泊酚组,每组80例。七氟醚组采用七氟醚-瑞芬太尼维持麻醉,丙泊酚组给予丙泊酚-瑞芬太尼维持麻醉。通过WFTSS和MASS对患者进行ERAS评估。记录麻醉恢复时间、符合ERAS的患者例数、不符合ERAS的相关因素与围手术期并发症。结果与MASS比较,WFTSS对ERAS的出手术室评估更加有效(P=0.031)。拔管时间方面,七氟醚组明显慢于丙泊酚组(P=0.030);在符合ERAS方面,丙泊酚组患者例数明显多于七氟醚组(P=0.026),入复苏室的患者例数明显少于七氟醚组,差异有统计学意义(P=0.025)。结论WFTSS可作为ERAS的出室标准之一。与七氟醚联合瑞芬太尼维持麻醉比较,丙泊酚联合瑞芬太尼维持麻醉能更快达到ERAS手术室内的拔管要求,且不良反应更小。

右美托咪定静脉泵注复合七氟醚吸入麻醉在子宫肌瘤手术患者中的应用效果

目的 观察右美托咪定静脉泵注复合七氟醚吸入麻醉应用于子宫肌瘤手术患者中的临床效果。方法 筛选子宫肌瘤手术患者68例,以随机数字表法划分为观察组与对照组进行对照研究,各34例。对照组患者给予生理盐水静脉泵注复合七氟醚吸入麻醉处理,观察组患者则采用右美托咪定静脉泵注复合七氟醚吸入麻醉处理。对比两组麻醉效果(完全清醒后疼痛程度、复苏期躁动程度及麻醉不良反应发生情况),麻醉实施前后应激指标(心率、收缩压、舒张压),手术指标(术后自主呼吸恢复时间、术后拔管时间、术后苏醒时间、术后首次下床时间、住院时间)及麻醉满意度。结果 观察组患者术后完全清醒后疼痛程度评分(3.2±0.6)分、复苏期躁动程度评分(1.6±0.5)分、麻醉不良反应发生率2.9%均低于对照组的(4.5±0.8)分、(2.0±0.7)分、17.6%,两组数据对比差值有统计学意义(P<0.05)。麻醉实施前两组心率和血压指标对比无明显差异(P>0.05);麻醉实施后观察组患者的心率(83.3±1.7)次/min、收缩压(128.3±1.8)mm Hg(1 mm Hg=0.133 kPa)、舒张压(95.4±1.5)mm Hg均低于对照组的(95.5±1.9)次/min、(132.8±2.3)mm Hg、(101.3±1.6)mm Hg,两组数据对比差值有统计学意义(P<0.05)。观察组患者术后自主呼吸恢复时间(13.5±1.5)min、术后拔管时间(3.1±0.8)d、术后苏醒时间(10.4±1.4)min、术后首次下床活动时间(20.6±1.2)h、住院时间(5.8±0.8)d均短于对照组的(17.8±1.8)min、(4.5±1.0)d、(15.6±1.6)min、(24.3±1.6)h、(7.6±1.0)d,两组数据对比差值有统计学意义(P<0.05)。观察组患者麻醉满意度为97.1%,高于对照组的82.4%,两组数据结果对比差值有统计学意义(P<0.05)。结论 将右美托咪定静脉泵注复合七氟醚吸入麻醉应用于子宫肌瘤手术患者当中,可有效提高临床手术麻醉效果及安全性,减少患者术中应激反应发生,减轻患者术后疼痛程度,提高术后身体恢复效率。

丙泊酚静脉麻醉复合腰硬联合麻醉在髋关节骨折手术中的应用效果

目的 分析在髋关节骨折手术中应用丙泊酚静脉麻醉复合腰硬联合麻醉的有效性。方法 选择72例髋关节骨折手术患者,按照掷硬币法分为观察组和对照组,每组36例。对照组施行腰硬联合麻醉,观察组施行丙泊酚静脉麻醉复合腰硬联合麻醉。对比两组术后12 h的疼痛评分、麻醉效果、血流动力学指标、认知功能情况。结果 观察组术后12 h的疼痛评分(1.92±0.21)分低于对照组的(2.46±0.23)分(P<0.05)。观察组麻醉优良率100.00%高于对照组的86.11%(P<0.05)。两组麻醉诱导前、手术结束拔管时心率及麻醉诱导前的血氧饱和度对比无明显差异(P>0.05);观察组麻醉5 min、麻醉30 min的心率分别为(69.38±5.12)、(67.27±5.23)次/min,低于对照组的(72.46±7.12)、(70.31±4.82)次/min(P<0.05);观察组麻醉5 min、麻醉30 min、手术结束拔管时血氧饱和度分别为(97.38±0.28)%、(98.32±0.28)%、(97.56±0.11)%,高于对照组的(95.77±0.25)%、(96.00±0.31)%、(95.64±0.54)%(P<0.05)。两组术前1 d简易精神状态检查量表(MMSE)评分对比无明显差异(P>0.05),观察组术后1 d、术后3 d和术后1周的MMSE评分分别为(24.11±1.33)、(26.88±1.21)、(28.31±0.98)分,高于对照组的(22.73±1.21)、(24.33±1.37)、(27.38±1.72)分(P<0.05)。结论 髋关节骨折手术中施行丙泊酚静脉麻醉复合腰硬联合麻醉的效果显著,有利于降低患者的术后疼痛感,稳定血流动力学指标,改善认知功能,值得推广。

静吸复合全身麻醉在妇科腔镜手术患者中的应用效果

目的:观察静吸复合全身麻醉在妇科腔镜手术患者中的应用效果。方法:选取2021年4月至2023年6月于该院行妇科腔镜手术治疗的300例患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各150例。对照组采用静脉全身麻醉,观察组采用静吸复合全身麻醉。比较两组麻醉相关指标(麻醉起效时间、麻醉清醒时间、拔管时间)水平,不同时间[麻醉诱导前5 min(T_(0))、手术开始后5 min(T_(1))、术毕(T_(2))]血流动力学指标(平均动脉压、心率)水平,术后不同时间疼痛[视觉模拟评分法(VAS)]评分、镇静(Ramsay镇静评分法)评分,以及不良反应发生率。结果:观察组麻醉起效时间、麻醉清醒时间、拔管时间均短于对照组,差异有统计学意义(P<0.05);T_(1)、T_(2)时,两组平均动脉压、心率水平均低于T_(0)时,但观察组高于对照组,差异有统计学意义(P<0.05);术后3、6 h,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05);术后5、15 min,观察组Ramsay镇静评分均高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:静吸复合全身麻醉应用于妇科腔镜手术患者可改善麻醉相关指标水平,稳定血流动力学指标水平,降低疼痛评分,提高镇静评分,效果优于静脉全身麻醉。

静吸复合麻醉对卵巢癌根治术患者手术相关指标的影响

目的探讨卵巢癌根治术采用静吸复合麻醉(IIA)对患者术中体征、脑氧代谢率及免疫功能的影响。方法选取2021年2月至2022年5月在监利市人民医院进行卵巢癌根治术(ROOC)治疗的76例患者作为研究对象,根据麻醉方式分别纳入TIA组和IIA组,各38例。TIA组进行全凭静脉麻醉(TIA),IIA组进行IIA。比较两组患者准备麻醉前(T_(0))、气管插管后(T_(1))、气管插管后10 min(T_(2))和手术结束(T_(3))时的心率(HR)、平均动脉压(MAP)、脑氧代谢指标[脑血流量/脑氧耗(CBF/CMRO_(2))、脑氧耗/脑糖耗(CMRO2/CMRGlu)和乳酸生成量(ADVL)]及麻醉期的各项指标,比较两组患者T_(0)、T_(3)、术后12 h和术后24 h的T淋巴细胞亚群指标。结果IIA组患者麻醉苏醒时间、恢复自主呼吸时间均显著短于TIA组(P<0.05)。术中两组患者HR和MAP均处于正常波动范围,且无显著差异(P>0.05)。T_(1)、T_(2)、T_(3)时与T_(0)时比较,IIA组患者CBF/CMRO_(2)、CMRO_(2)/CMRGlu、ADVL均显著升高(P<0.05),TIA组患者CBF/CMRO2、ADVL显著升高(P<0.05);IIA组患者CBF/CMRO2、ADVL升高幅度显著小于TIA组(P<0.05),CMRO_(2)/CMRGlu升高幅度显著大于TIA组(P<0.05)。T_(3)、术后12 h和术后24 h,与TIA组相比,IIA组患者CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平较高(P<0.05);T_(3)和术后12 h,与T_(0)相比,IIA组患者CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平显著降低(P<0.05);T_(3)、术后12 h和术后24 h,与麻醉前相比,TIA组患者CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平均显著降低(P<0.05)。结论进行IIA的ROOC患者苏醒和恢复自主呼吸用时较短,对脑氧代谢平衡和免疫相关T淋巴细胞亚群影响较小,安全性较高。

七氟烷静吸复合麻醉与全凭静脉麻醉对老年股骨颈骨折手术患者术后认知功能恢复及并发症的影响

目的研究七氟烷静吸复合麻醉及全凭静脉麻醉对老年股骨颈骨折手术患者认知功能恢复及并发症的影响。方法随机选取2022年5月—2023年5月于福建省龙岩市龙岩人民医院行手术治疗的老年股骨颈骨折患者120例作为研究对象,以不同麻醉方法分为对照组和观察组,各60例,对照组行全凭静脉麻醉,观察组行七氟烷静吸复合麻醉,对比两组各时间点的基础生命体征、术后认知功能以及并发症。结果切皮后30 min(T_(2)),观察组心率、平均动脉压水平均高于对照组,差异有统计学意义(P均<0.05);而麻醉前(T_(0))、麻醉诱导后5 min(T_(1)),两组心率、平均动脉压水平对比,差异无统计学意义(P均>0.05)。术后3 h、12 h观察组的蒙特利尔认知评估量表得分均高于对照组,差异有统计学意义(P均<0.05)。观察组并发症总发生率为6.67%(4/60),低于对照组的20.00%(12/60),差异有统计学意义(χ^(2)=4.615,P=0.031)。结论七氟烷静吸复合麻醉用于老年股骨颈骨折手术患者的麻醉处理,更有利于稳定患者的基础生命征,可以加快恢复其认知功能,并保障麻醉安全。