七氟醚与丙泊酚联合瑞芬太尼用于腹腔镜减肥手术患者术后恢复质量的比较
Comparison of sevoflurane and propofol in combination with remifentanil on the quality of postoperative recovery in patients undergoing laparoscopic bariatric surgery.
作者信息
Shu Zhuolin, Lin Tiancheng, Xu Dingchen, Zheng Shuyuan
机构信息
Department of Anesthesiology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
Front Med (Lausanne). 2024 Jul 24;11:1382724. doi: 10.3389/fmed.2024.1382724. eCollection 2024.
OBJECTIVE
This study aimed to evaluate and compare the effects of sevoflurane + remifentanil (Sev + Rem) and propofol + remifentanil (Pro + Rem) on the postoperative recovery quality of patients undergoing laparoscopic bariatric surgery to determine which anesthesia regimen provides a better overall recovery experience.
METHODS
Sixty patients were divided into two groups based on the treatments they underwent: Sev + Rem ( = 30) and Pro + Rem ( = 30). The Sev + Rem group received sevoflurane inhalation (0.5%, increasing to 0.5-4%) and remifentanil via target-controlled infusion. The Pro + Rem group received propofol [4-8 mg/(kg·h)] and remifentanil via target-controlled infusion. Anesthesia depth was maintained at a bispectral index of 40-60 in both groups. Perioperative data, hemodynamic parameters, and postoperative recovery quality were assessed.
RESULTS
Compared to the Pro + Rem group, the dose of remifentanil in the Sev + Rem group was significantly lower (1693.67 ± 331.75 vs. 2,959 ± 359.77, < 0.001), the proportion of patients used norepinephrine was markedly higher [16 (53.33) vs. 8 (26.67), = 0.035], and the time of extubation was earlier (356.33 ± 63.17 vs. 400.3 ± 50.11, = 0.004). The Hemodynamic results showed the HR in the Sev + Rem group was faster than that in the Pro + Rem group at the beginning of surgery and 1 h post-surgery (67.37 ± 4.40 vs. 64.33 ± 4.44, = 0.010, 69.07 ± 4.23 vs. 66.40 ± 5.03, = 0.030). In regard to the assessment of postoperative recovery quality, the emotional state scores in the Sev + Rem group were significantly lower than the Pro + Rem group (36.83 ± 2.79 vs. 39.50 ± 4.64, = 0.009).
CONCLUSION
The two anesthesia modalities (Sev + Rem and Pro + Rem) have their advantages and disadvantages for patients undergoing laparoscopic bariatric surgery and have comparable effects on postoperative recovery quality.
目的
本研究旨在评估和比较七氟醚+瑞芬太尼（Sev+Rem）与丙泊酚+瑞芬太尼（Pro+Rem）对接受腹腔镜减肥手术患者术后恢复质量的影响，以确定哪种麻醉方案能提供更好的整体恢复体验。
方法
60例患者根据所接受的治疗分为两组：Sev+Rem组（n=30）和Pro+Rem组（n=30）。Sev+Rem组通过靶控输注接受七氟醚吸入（0.5%，增至0.5-4%）和瑞芬太尼。Pro+Rem组通过靶控输注接受丙泊酚[4-8mg/（kg·h）]和瑞芬太尼。两组的麻醉深度均维持在脑电双频指数40-60。评估围手术期数据、血流动力学参数和术后恢复质量。
结果
与Pro+Rem组相比，Sev+Rem组瑞芬太尼剂量显著更低（1693.67±331.75 vs.2959±359.77，P<0.001），使用去甲肾上腺素的患者比例显著更高[16（53.33%）vs.8（26.67%），P=0.035]，拔管时间更早（356.33±63.17 vs.400.3±50.11，P=0.004）。血流动力学结果显示，手术开始时和术后1小时，Sev+Rem组的心率快于Pro+Rem组（67.37±4.40 vs.64.33±4.44，P=0.010；69.07±4.23 vs.66.40±5.03，P=0.030）。在术后恢复质量评估方面，Sev+Rem组的情绪状态评分显著低于Pro+Rem组（36.83±2.79 vs.39.50±4.64，P=0.009）。
结论
两种麻醉方式（Sev+Rem和Pro+Rem）对接受腹腔镜减肥手术的患者各有优缺点，对术后恢复质量的影响相当。
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