摘要
【目的】探讨行右美托咪定(Dex)复合丙泊酚麻醉对胆囊结石手术患者的麻醉效果及认知功能的影响。【方法】160例胆囊结石患者,随机分为观察组和对照组,每组80例。两组患者均行腹腔镜胆囊切除术(LC),对照组使用丙泊酚静脉麻醉,观察组在此基础上联合Dex麻醉。比较两组患者手术相关指标,麻醉前及拔管后血流动力学指标[平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))],术中瑞芬太尼与丙泊酚的用量以及精神状态、疼痛评分,不良反应发生情况。【结果】两组患者手术时间、术中出血量比较,差异无统计学意义(P>0.05);观察组麻醉起效时间、麻醉苏醒时间、恢复自主呼吸时间显著短于对照组(P<0.05)。两组拔管后MAP、HR水平低于麻醉前,SpO_(2)水平高于麻醉前(P<0.05),且观察组MAP、SpO_(2)高于对照组,HR低于对照组(P<0.05)。观察组瑞芬太尼与丙泊酚用量均少于对照组(P<0.05);两组患者术后2 h简易精神状态量表(MMSE)、视觉模拟疼痛量表(VAS)评分显著低于术后6 h(P<0.05),观察组术后2 h、6 h MMSE评分高于对照组,VAS评分低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】Dex复合丙泊酚用于LC的镇痛效果显著,具有起效快、苏醒快、自主呼吸恢复快的特点,可减少麻醉药用量,维持血流动力学稳定,对患者术后认知影响小,且安全性较好。
【Objective】To investigate the anesthetic effect and cognitive function impact of dexmedetomidine(Dex)combined with propofol anesthesia in patients undergoing gallstone surgery.【Methods】A total of 160 patients with gallstones were randomly divided into the observation group and the control group,with 80 cases in each group.Both groups underwent laparoscopic cholecystectomy(LC).Patients in the control group received intravenous propofol anesthesia,while the observation group received Dex combined with propofol anesthesia.Surgical-related indicators,hemodynamic parameters before anesthesia and after extubation[mean arterial pressure(MAP),heart rate(HR),and oxygen saturation(SpO_(2))],intraoperative dosages of remifentanil and propofol,mental state,pain scores,and the occurrence of adverse reactions were compared between the two groups.【Results】There were no significant differences in surgical time and intraoperative blood loss between the two groups(P>0.05).The onset time of anesthesia,anesthesia recovery time,and recovery time of spontaneous breathing in the observation group were significantly shorter than those in the control group(P<0.05).The MAP and HR levels of both groups after extubation were lower than before anesthesia,and SpO_(2) level was higher than before anesthesia(P<0.05).Moreover,the MAP and SpO_(2) of the observation group were higher than those of the control group,while HR was lower than the control group(P<0.05).The dosages of remifentanil and propofol in the observation group were lower than those in the control group(P<0.05).The Mini-Mental State Examination(MMSE)and Visual Analog Scale(VAS)scores at 2 hours post-operation were significantly lower than at 6 hours post-operation in both groups(P<0.05).The MMSE scores at 2 hours and 6 hours post-operation in the observation group were higher than those in the control group,while the VAS scores were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).【Conclusion】The combination of Dex and propofol for LC provides significant analgesic effects,characterized by rapid onset,recovery,and spontaneous breathing recovery.It can reduce the dosage of anesthetic drugs,maintain hemodynamic stability,and have a minimal impact on postoperative cognitive function.It is safe.
作者
吕学良
姜朋
李现虎
LYU Xueliang;JIANG Peng;LI Xianhu(Department of Anesthesiology,Shandong Provincial Third Hospital,Jinan Shandong 250031)
出处
《医学临床研究》
CAS
2024年第6期889-892,共4页
Journal of Clinical Research
