Jiang Wei, Wang Jun, Ni Xin-Xin, Huang Zu-Chao
Department of Anesthesiology, Huishan District People's Hospital, Wuxi, Jiangsu, China.
Department of Anesthesiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China.
Evid Based Complement Alternat Med. 2022 Jul 15;2022:9147416. doi: 10.1155/2022/9147416. eCollection 2022.
To investigate the anesthesia effect of remifentanil combined with propofol for laparoscopic cholecystectomy and its impact on postoperative cognitive recovery.
A total of 120 patients who underwent laparoscopic cholecystectomy in our hospital from February 2019 to June 2021 were recruited and assigned into either control group or experimental group at a ratio of 1 : 1 via the random number table method. The patients in the control group were anesthetized with fentanyl combined with propofol, and the patients in the experimental group were anesthetized with remifentanil combined with propofol. The clinical basic indicators (extubation time, recovery time, breathing recovery time, and orientation recovery time), and observer's assessment of awareness/sedation (OAA/S) scores and complications were compared between the two groups.
There was no significant difference in extubation time between the two groups ( > 0.05). The postoperative wake-up time, respiratory recovery time, and orientation recovery time of the experimental group were significantly better than those of the control group ( < 0.05). The OAA/S scores of the patients in the experimental group were significantly higher than those in the control group immediately after surgery, 1 h after surgery, and 3 h after surgery ( < 0.05). There was no significant difference in the OAA/S scores between the two groups on the 1st day after operation ( > 0.05). The incidence of complications in the experimental group was significantly lower than that in the control group ( < 0.05).
Remifentanil + propofol for laparoscopic cholecystectomy patients has a significant anesthesia effect. This strategy effectively shortens the extubation, awakening, respiratory recovery, orientation recovery time of patients, and OAA/S score, suggest a minor impact on the postoperative cognitive function and state of consciousness. It has a high safety profile and thus is worthy of clinical application.
探讨瑞芬太尼联合丙泊酚用于腹腔镜胆囊切除术的麻醉效果及其对术后认知恢复的影响。
选取2019年2月至2021年6月在我院行腹腔镜胆囊切除术的120例患者，采用随机数字表法按1∶1比例分为对照组和试验组。对照组患者采用芬太尼联合丙泊酚麻醉，试验组患者采用瑞芬太尼联合丙泊酚麻醉。比较两组患者的临床基本指标（拔管时间、苏醒时间、呼吸恢复时间、定向力恢复时间）、观察者对意识/镇静的评估（OAA/S）评分及并发症情况。
两组患者拔管时间比较，差异无统计学意义（>0.05）。试验组患者术后苏醒时间、呼吸恢复时间及定向力恢复时间均明显优于对照组（<0.05）。试验组患者术后即刻、术后1 h及术后3 h的OAA/S评分均明显高于对照组（<0.05）。术后第1天两组患者OAA/S评分比较，差异无统计学意义（>0.05）。试验组患者并发症发生率明显低于对照组（<0.05）。
瑞芬太尼+丙泊酚用于腹腔镜胆囊切除术患者具有显著的麻醉效果。该方案有效缩短了患者的拔管、苏醒、呼吸恢复、定向力恢复时间及OAA/S评分，提示对术后认知功能及意识状态影响较小。其安全性高，值得临床应用。
