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丙泊酚联合瑞芬太尼可减少接受腹腔镜胆囊切除术患者的不良反应。

Propofol combined with remifentanil reduces the adverse reactions of patients undergoing laparoscopic cholecystectomies.

作者信息

Chen Juhui, Ying Xiaogang, Yang Danfeng

机构信息

Department of Anesthesiology, College of Medicine, Zhejiang University, Sir Run Run Shaw Hospital Hangzhou 310015, Zhejiang Province, China.

出版信息

Am J Transl Res. 2021 Jun 15;13(6):6560-6567. eCollection 2021.

Abstract

OBJECTIVE

To explore the effectiveness of using isoflurane and propofol combined with remifentanil in laparoscopic cholecystectomies (LC).

METHODS

A total of 118 patients undergoing LC in our hospital from April 2018 to January 2019 were recruited as the study cohort. 56 of the patients were anesthetized with isoflurane combined with remifentanil during their operations (the IR group), and the other 62 patients were anesthetized with propofol combined with remifentanil during their operations (the PR group). The effects of the two anesthesia methods on the hemodynamics and stress responses were compared, and the postoperative recoveries, adverse reactions, analgesia, and cognitive functions were recorded.

RESULTS

Compared with the IR group, the average arterial pressure, heart rate, norepinephrine, and cortisol decreased in the PR group. Compared with the IR group, the total postoperative adverse reaction rate was lower in the PR group. Compared with the IR group, the spontaneous respiration recovery times, the times to opening eyes, and the extubation times were significantly shortened in the PR group. There was no significant difference in the postoperative pain levels between the two groups. Compared with the IR group, the postoperative cognitive function assessment was better in the PR group.

CONCLUSION

Compared with isoflurane combined with remifentanil, propofol combined with remifentanil has a smaller impact on the hemodynamics and cognitive functions of patients undergoing LC, and it causes a more significant reduction in the stress response. In addition, its postoperative adverse reactions are lower, so it is worthy of promoting in clinical practice.

摘要

目的

探讨异氟烷和丙泊酚联合瑞芬太尼用于腹腔镜胆囊切除术(LC)的有效性。

方法

选取2018年4月至2019年1月在我院接受LC的118例患者作为研究队列。其中56例患者在手术期间采用异氟烷联合瑞芬太尼进行麻醉(IR组),另外62例患者在手术期间采用丙泊酚联合瑞芬太尼进行麻醉(PR组)。比较两种麻醉方法对血流动力学和应激反应的影响,并记录术后恢复情况、不良反应、镇痛效果及认知功能。

结果

与IR组相比,PR组的平均动脉压、心率、去甲肾上腺素和皮质醇水平降低。与IR组相比,PR组术后总不良反应发生率较低。与IR组相比,PR组的自主呼吸恢复时间、睁眼时间和拔管时间明显缩短。两组术后疼痛程度无显著差异。与IR组相比,PR组术后认知功能评估较好。

结论

与异氟烷联合瑞芬太尼相比,丙泊酚联合瑞芬太尼对LC患者的血流动力学和认知功能影响较小,对应激反应的降低更为显著。此外,其术后不良反应较少,因此值得在临床实践中推广。

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