老年腹腔镜手术患者应用瑞芬太尼与七氟烷复合麻醉的效果

betway必威登陆网址（betway.com ）学报››2021,Vol. 42››Issue (6): 442-444.DOI:10.3969/j.issn.2097-0005.2021.06.012

老年腹腔镜手术患者应用瑞芬太尼与七氟烷复合麻醉的效果

何友利¹, 孔静²

菏泽医学专科学校 1.麻醉学教研室;
菏泽医学专科学校 2.护理系,山东菏泽 274000

收稿日期:2020-12-18出版日期:2021-06-25发布日期:2021-08-25
作者简介:何友利(1975—),男,山东菏泽人,副教授,本科,主要从事临床麻醉学工作。E-mail:270006953@qq.com。
基金资助:
菏泽医学专科学校附属医院科研项目(HYFY202024)。

Effect of combined anesthesia of remifentanil and sevoflurane in elderly patients undergoing laparoscopic surgery

He Youli¹, Kong Jing²

1. Dept. of Anesthesiology,Heze 274000,China;
2. Dept. of Nursing,Heze Medical College,Heze 274000,China

Received:2020-12-18Online:2021-06-25Published:2021-08-25

摘要/Abstract

摘要：目的观察老年腹腔镜手术患者应用瑞芬太尼与七氟烷复合麻醉的效果。方法选取2019年1月—2020年6月就诊于菏泽医学专科学校附属医院的老年腹腔镜手术患者90例,按照随机数字表法分为对照组(n=45)和观察组(n=45)。对照组应用瑞芬太尼麻醉,观察组应用七氟烷与瑞芬太尼复合麻醉。比较两组各时点SOMCT评分、Steward 苏醒评分、拔管、苏醒时间及不良反应。结果两组拔管后1 h、3 h时SOMCT评分对比发现观察组优于对照组(P<0.05),差异有统计学意义。两组拔管时、拔管15 min时Steward 苏醒评分对比发现观察组优于对照组(P<0.05),差异有统计学意义。两组拔管、苏醒时间对比发现,观察组优于对照组(P<0.05),差异有统计学意义。两组不良反应率对比发现观察组优于对照组(P<0.05),差异有统计学意义。结论老年腹腔镜手术患者应用七氟烷与瑞芬太尼复合麻醉的效果显著,即对术后短期认知功能影响小,可提升苏醒质量,不良反应少,促进患者术后恢复,值得推广研究。

关键词:老年,腹腔镜手术,七氟烷,瑞芬太尼,复合麻醉,认知功能

Abstract:Objective: To observe the effect of combined anesthesia of remifentanil and sevoflurane in elderly patients undergoing laparoscopic surgery. Methods: A total of 90 elderly patients undergoing laparoscopic surgery in our hospital from January 2019 to June 2020 were selected and divided into control group (n=45) and observation group (n=45) according to random number table method.The control group was anesthetised with remifentanil, and the observation group was anesthetised with combined sevoflurane and remifentanil.SOMCT score, Steward resuscitation score, extubation, resuscitation time and adverse reactions were compared between the two groups at each time point. Results: The comparison of SOMCT scores at 1h and 3h after extubation between the two groups showed that the observation group was better than the control group (P<0.05), which was statistically significant.Comparison of Steward recovery scores at extubation and 15min extubation between the two groups showed that the observation group was better than the control group (P<0.05), which was statistically significant.The comparison of extubation and recovery time between the two groups showed that the observation group was better than the control group (P<0.05), which had statistical value. Comparison of adverse reaction rate between the two groups showed that observation group was better than control group (P<0.05), which was statistically significant. Conclusion: Combined anesthesia of sevoflurane and Remifentanil has a significant effect on postoperative short-term cognitive function in elderly patients undergoing laparoscopic surgery.In other words, it has little influence on postoperative short-term cognitive function, can improve the quality of recovery, and promote postoperative recovery of patients with fewer adverse reactions. Therefore, it is worth promoting research.

Key words:old age,laparoscopic surgery,sevoflurane,remifentanil,compound anesthesia,cognitive function

中图分类号:

R614

何友利, 孔静. 老年腹腔镜手术患者应用瑞芬太尼与七氟烷复合麻醉的效果[J]. betway必威登陆网址（betway.com ）学报, 2021, 42(6): 442-444.

He Youli, Kong Jing. Effect of combined anesthesia of remifentanil and sevoflurane in elderly patients undergoing laparoscopic surgery[J]. Journal of Shandong First Medical Unversity & Shandong Academy of Medical Sciences, 2021, 42(6): 442-444.

参考文献

[1] 张军红,张新红.七氟烷复合瑞芬太尼用于老年人腹腔镜胆囊切除术麻醉的比较[J].中国医药指南,2017,13(26):164-165.
[2] 张浩.腹腔镜手术患者应用七氟烷或异丙酚复合瑞芬太尼麻醉的临床观察[J].中国医学创新,2019,16(05):156-159.
[3] 邓国华.瑞芬太尼联合七氟烷麻醉对患者术后认知功能的影响[J].世界最新医学信息文摘,2019,19(99):237+240.
[4] 宋村笛,姜虹.七氟烷复合瑞芬太尼对腹腔镜子宫切除术患者应激指标与麻醉效果的影响[J].医学综述,2020,26(10):2070-2074+2080.
[5] 董昭,赵君,刘晓东.地氟烷-瑞芬太尼静吸复合全麻用于老年腹腔镜胆囊切除术30例[J].中国中西医结合外科杂志,2017,23(02):197-200.
[6] 万云芳,张文元,颜云.探讨七氟烷和丙泊酚麻醉对腹腔镜胆囊患者全麻手术后认知功能的影响[J].中外医疗,2017,36(15):123-125.
[7] 李玉坤,王存斌,刘晓东.地氟烷-瑞芬太尼静吸复合全麻用于老年腹腔镜辅助阴式子宫全切术的麻醉效果观察[J].中国处方药,2017,15(07):65-66.
[8] 汤龙信,王金保.不同浓度吸入性麻醉药七氟烷对老年腹腔镜手术患者苏醒期躁动的影响[J].临床误诊误治,2016,29(05):91-94.
[9] 黄国振.七氟烷与丙泊酚分别复合瑞芬太尼对腹腔镜胆囊切除术患者血流动力学的影响比较[J].当代医学,2020,26(29):93-95.
[10] 魏永胜.瑞芬太尼联合丙泊酚用于高龄腹腔镜胆囊切除术中的临床麻醉效果[J].医学食疗与健康,2020,18(22):85+87.
[11] 周雷.七氟烷复合瑞芬太尼对腹腔镜子宫切除术患者应激指标与麻醉效果的影响[J].中国农村卫生,2020,12(20):16.
[12] 张楚祺,胡彩霞.瑞芬太尼联合丙泊酚对腹腔镜胆囊切除术患者应激反应和血气指标的影响[J].临床合理用药杂志,2020,13(30):80-82.
[13] 屈晓莉,乔杰,宋巍,等.七氟烷复合瑞芬太尼麻醉对腹腔镜手术患者生命体征稳定、苏醒效果的影响[J].临床医学研究与实践,2020,5(29):98-100.
[14] 王倩琳,张志军.瑞芬太尼与七氟烷复合麻醉对老年腹腔镜手术患者术后短期认知功能的影响[J].实用药物与临床,2019,22(02):148-151.
[15] 徐明禹,何建斌,袁静.七氟烷复合瑞芬太尼麻醉对老年腹腔镜患者术后认知功能的影响[J].航空航天医学杂志,2020,31(07):839-841.