[1]张海亮,郝静静,白延斌,等.静吸复合与全凭静脉麻醉在妇科腹腔镜手术中的临床应用研究*[J].陕西医学杂志,2019,(8):1038-1041.
　ZHANG Hailiang,HAO Jingjing,BAI Yanbin,et al.Clinical study on the combination of static aspiration and total intravenous anesthesia in gynecologic laparoscopic surgery[J].,2019,(8):1038-1041.
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静吸复合与全凭静脉麻醉在妇科腹腔镜手术中的临床应用研究*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年8期
页码:
1038-1041
栏目:
临床研究
出版日期:
2019-08-05

文章信息/Info

Title:
Clinical study on the combination of static aspiration and total intravenous anesthesia in gynecologic laparoscopic surgery
文章编号:
DOI:10.3969/j.issn.1000-7377.2019.08.022
作者:
张海亮; 郝静静; 白延斌; 路喻清; 呼延静
延安大学附属医院（延安716000）
Author(s):
ZHANG Hailiang; HAO Jingjing; BAI Yanbin; et al.
Yan’an University Affiliated Hospital（Yan’an 716000）
关键词:
静吸复合; 全凭静脉; 腔镜手术; 妇科; 血流动力学; 胃肠功能恢复
Keywords:
Key words Intravenous-inhalation combined anesthesia; Total intravenous anesthesia; Endoscopic surgery; Gynaecology; Hemodynamic; Gastrointestinal function recovery
分类号:
R614.2
文献标志码:
A
摘要:
摘 要 目的：观察对比丙泊酚、七氟醚分别复合瑞芬太尼在妇科腹腔镜手术中的应用效果。方法：选取择期行妇科腹腔镜手术患者80例,ASA分级I～Ⅲ级，随机分为丙泊酚组(PR组)和七氟醚组(SR组)各40例。PR组给予全凭静脉诱导与术中维持，SR组给予静吸复合诱导与维持，两组患者均通过BIS值监测麻醉深度（BIS值维持在40～60）。观察两组患者术中麻醉药物使用量；两组患者呼吸恢复时间、苏醒时间、拔管时间；两组患者不同时间点血流动力学改变；两组患者苏醒期不良反应情况；两组患者术后出现肛门排气、排便时间；两组患者拔管后10 min镇静躁动评分（RSAS）和疼痛评分（VAS）。结果：SR组患者术中静脉全麻药物（瑞芬太尼、顺式阿曲库铵）使用总量明显少于PR组患者 (P＜0.05),SR组患者呼吸恢复时间、意识恢复时间、拔管时间明显短于PR组患者（P＜0.05）,SR组血流动力学更稳定(P＜0.05)。SR组患者术后排气、排便时间都短于PR组患者（P＜0.05）。结论：两组麻醉方式都能满足手术需求。七氟醚组术中麻醉药物使用量明显减少、血流动力学更加稳定且术后胃肠功能恢复较快。
Abstract:
Abstract Objective：To observe and compare the effect of propofol and sevoflurane combined with remifentanil in gynecological laparoscopic surgery. Methods: 80 patients undergoing elective gynecological laparoscopic surgery, ASA graded Ⅰ～Ⅲ level, were randomly divided into propofol group (PR group, n=40) and sevoflurane group (SR group, n=40). The PR group was treated with total intravenous induction and intraoperative maintenance. The patients in SR group were induced and maintained by intravenous aspiration. The depth of anesthesia was monitored by BIS (BIS maintained at 40 - 60). To observe the use of anesthetics during operation, respiratory recovery time, recovery time and extubation time in the two groups, hemodynamic changes at different time points in the two groups, adverse reactions in the two groups during recovery period, and respiratory recovery time, recovery time and extubation time in the two groups. Anal exsufflation and defecation time occurred in both groups after operation, sedation and restlessness score (RSAS) and pain score (VAS).10 min after extubation in both groups. Results: The total amount of intravenous general anesthesia drugs (remifentanil, cisatracurium) in SR group was significantly less than that in PR group (P＜0.05).The extubation time was significantly shorter than that in PR group (P＜0.05). The hemodynamics of patients in SR group was more stable (P＜0.05). The postoperative exhaust and defecation time in SR group were shorter than those in PR group (P＜0.05).Conclusion: Both groups of anesthesia can meet the needs of operation. In sevoflurane group,the use of anesthetics was significantly decreased, hemodynamics was more stable and gastrointestinal function recovered quickly after operation.

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备注/Memo

备注/Memo:
*陕西省自然科学基础研究计划项目（2018JM7067）
更新日期/Last Update: 2019-08-13