摘要
【目的】探讨七氟醚复合麻醉对妇科腹腔镜手术患者血流动力学、疼痛因子水平的影响。【方法】在本院行腹腔镜手术治疗的86例妇科疾病患者,随机分为观察组和对照组,每组43例。对照组行异丙酚复合麻醉,观察组行七氟醚复合麻醉。比较两组麻醉情况;比较诱导前(T_(0))、插管时(T_(1))、插管5 min(T_(2))、切皮时(T_(3))、气腹后(T_(4))、拔管时(T_(5))的心率(HR)、平均动脉压(MAP)等血流动力学指标;比较术前和术后6 h、12 h、24 h血清5羟色胺(5-HT)、前列腺素E_(2)(PGE_(2))、β内啡肽(β-EP)及P物质(SP)等疼痛因子水平及术后不良反应发生情况。【结果】两组麻醉时间比较,差异无统计学意义(P>0.05);观察组恢复自主呼吸时间、睁眼时间、语言应答时间、恢复定向力时间及拔管时间均短于对照组(P<0.05)。T_(3)时,观察组HR高于对照组(P<0.05);T_(2)、T_(3)、T_(4)时,观察组MAP均高于对照组相应时点(P<0.05);两组其他时点HR、MAP比较,差异均无统计学意义(P>0.05)。两组术前及术后各时点的5-HT、PGE_(2)、β-EP、SP及不良反应发生率比较,差异均无统计学意义(P>0.05)。【结论】七氟醚复合麻醉可维持妇科腹腔镜手术患者血流动力学稳定,促进患者术后复苏,有效调节疼痛因子水平,且不良反应发生率较低。
【Objective】To investigate the effects of sevoflurane combined anesthesia on hemodynamics and pain factors in patients undergoing gynecological laparoscopic surgery.【Methods】There were 86 patients with gynecological diseases treated by laparoscopic surgery in our hospital and random divided into the observation group and the control group(n=43).The control group received propofol combined anesthesia,and the observation group received sevoflurane combined anesthesia.The anesthesia effects,heart rate(HR),mean arterial pressure(MAP)and other hemodynamic indicators before induction(T_(0)),intubation(T_(1)),intubation 5 min(T_(2)),skin incision(T_(3)),post-pneumoperitoneum(T_(4)),and extubation(T_(5))were compared between the two groups.Serum levels of pain factors such as 5-HT,PGE_(2),β-endorphin(β-EP)and substance P(SP)at 6 h,12 h and 24 h postoperatively,and the occurrence of postoperative adverse reactions of the two groups was compared as well.【Results】There was no difference in anesthesia time between the two groups(P>0.05).The recovery time of spontaneous breathing,eye opening time,language response time,recovery time of orientation and extubation time in observation group were shorter than those in control group(P<0.05).At T_(3),HR of observation group was higher than that of control group at the same point(P<0.05).At T_(2),T_(3) and T_(4),the MAP of observation group was higher than that of control group(P<0.05).There were no differences in HR and MAP between the two groups at other time points(P>0.05).There were no differences in the incidence of 5-HT,PGE_(2),β-EP,SP and adverse reactions between two groups before and after operation(P>0.05).【Conclusion】sevoflurane combined anesthesia can maintain hemodynamic stability,promote postoperative resuscitation and effectively regulate pain factors in patients undergoing gynecological laparoscopic surgery,and the incidence of adverse reactions is low.
作者
唐慧
黄唯
李彬
蔡玲
TANG Hui;HUANG Wei;LI Bin(Department of Anesthesiology,Changning District Maternal and Child Health Hospital,Shanghai 200050)
出处
《医学临床研究》
CAS
2024年第5期739-742,共4页
Journal of Clinical Research
关键词
七氟醚
腹腔镜检查
妇科外科手术
血流动力学
麻醉
Sevoflurane
Laparoscopy
Gynecologic Surgical Procedures
Hemodynamics
Anesthesia
