摘要
目的:探讨靶控输注丙泊酚与瑞芬太尼对胆囊切除术患者血流动力学和术后认知水平的影响。方法:选取86例行腹腔镜胆囊切除术患者,分为对照组(静脉输注丙泊酚、芬太尼)和试验组(靶控输注丙泊酚、瑞芬太尼),各43例。比较两组围手术期心率、血压、数字疼痛强度量表(NRS)、警觉镇静评分量表(OAAS)、简易精神状态量表(MMSE)评分、术后恢复及术后并发症的发生情况。结果:①相比插管前水平,两组插管后心率和舒张压均明显提高(P<0.05);试验组插管前、插管后心率和血压水平与对照组比较,均无统计学差异(P>0.05)。②两组拔管后24 h时NRS评分均低于拔管时,对照组OAAS评分高于拔管时,试验组OAAS和MMSE评分均高于拔管时(P<0.05);试验组拔管后24 h时NRS评分较对照组明显减少,MMSE评分较对照组明显提高(P<0.05)。③试验组定向力完全恢复时间较对照组明显缩短(P<0.01);两组麻醉时间、拔管时间、术后睁眼时间、自主呼吸恢复时间比较,均无统计学差异(P>0.05)。④两组患者术后并发症发生率比较无统计学差异(P>0.05)。结论:靶控输注丙泊酚与瑞芬太尼在胆囊切除术患者中具有麻醉效果明显和苏醒质量良好等优势。
Objective:To analyze the effects of target controlled infusion of propofol and remifentanil on hemodynamics and postoperative cognitive level in patients undergoing cholecystectomy.Methods:86 patients treated with laparoscopic cholecystectomy were selected and divided into control group(intravenous infusion of propofol and fentanyl) and experimental group(target controlled infusion of propofol and remifentanil),43 cases in each group.The perioperative heart rate,blood pressure,NRS score,OAAS score,MMSE score,postoperative recovery and postoperative complications were compared.Results:Compared with the level before intubation,the heart rate and diastolic blood pressure of the two groups after intubation were significantly increased(P<0.05).There was no significant difference in the levels of heart rate and blood pressure between the two groups before and after intubation(P>0.05).The NRS scores at 24 hours after extubation in the two groups were lower than those at extubation,the OAAS score in the control group was higher than that at extubation,and the OAAS and MMSE scores in the experimental group were higher than those at extubation(P<0.05).The NRS score at 24 hours after extubation in the experimental group was significantly lower than that in the control group,and the MMSE score was significantly higher than that in the control group(P<0.05).Compared with the control group,the complete recovery time of orientation in the experimental group was significantly shorter than that in the control group(P<0.01).There was no significant difference in anesthesia time,extubation time,postoperative eye opening time and spontaneous breathing recovery time between the two groups(P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Target controlled infusion of propofol and remifentanil in patients treated with cholecystectomy has obvious anesthetic effect and good quality of recovery and other advantages.
作者
庄莹莹
屈丽虹
闫辉
ZHUANG Yingying;QU Lihong;YAN Hui(Tangdu Hospital of Air Force Medical University,Xian 710038)
出处
《陕西医学杂志》
CAS
2020年第11期1479-1481,F0003,共4页
Shaanxi Medical Journal
基金
国家自然科学基金资助面上项目(31570845)。
关键词
胆囊切除术
瑞芬太尼
丙泊酚
血流动力学
认知水平
靶控输注
Cholecystectomy
Remifentanil
Propofol
Hemodynamics
Cognitive level
Tarteg controlled infusion
