全凭静脉联合喉罩七氟醚吸入麻醉在腹腔镜辅助阴式子宫全切术中的应用
Application value of total intravenous combined with sevoflurane laryngeal mask inhalation anesthesia in laparoscopic assisted vaginal hysterectomy
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摘要: 目的：分析腹腔镜辅助下行阴式子宫全切术时全凭静脉联合喉罩七氟醚吸入麻醉的效果。方法：选取拟行阴式子宫全切术病人100例，对照组47例，全凭静脉麻醉方式；观察组53例，实施全凭静脉联合喉罩七氟醚吸入麻醉。对比分析2组麻醉不同时间段内平均动脉压、心率、术后苏醒时间、麻醉起效时间、术后出现疼痛及给药时间。结果：2组病人T1、T2时间点平均动脉压及心率差异均无统计学意义（P>0.05）；从T3时间点开始，观察组平均动脉压及心率均明显高于对照组（P<0.01）。观察组术后苏醒时间及麻醉起效时间均明显短于对照组（P<0.01）。术后出现疼痛及给药时间均明显高于对照组（P<0.01）。结论：腹腔镜辅助下阴式子宫全切术中实施全凭静脉联合喉罩七氟醚吸入麻醉，可有效缩短麻醉起效及术后苏醒用时，临床应用效果较优。Abstract: Objective: To analyze the application value of total intravenous combined with sevoflurane laryngeal mask inhalation anesthesia in laparoscopic assisted vaginal hysterectomy.Methods: One hundred patients scheduled by vaginal hysterectomy were divided into the control group(n=47) and observation group(n=53).The control group and observation group were anesthetized using total intravenous method,and total intravenous combined with sevoflurane laryngeal mask inhalation method,respectively.The mean arterial pressure,heart rate,postoperative recovery time,anesthetic initiation time,and postoperative pain and administration time between two groups were compared.Results: The differences of the mean arterial pressure and heart rate between two groups at T1 and T2 were not statistically significant(P>0.05).After T3,the mean arterial pressure and heart rate in observation group were significantly higher than those in control group(P<0.01).The postoperative awakening time and onset time of anesthesia in observation group were significantly shorter than those in control group(P<0.01),and the postoperative pain time and administration time in observation group was significantly higher than those in control group(P<0.01).Conclusions: The application of total intravenous combined with sevoflurane laryngeal mask inhalation anesthesia in laparoscopic assisted vaginal hysterectomy can effectively shorten the onset time of anesthesia and postoperative awakening time,which has better clinical effect.
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Key words:
- hysterectomy /
- laparoscopy /
- total intravenous /
- laryngeal mask /
- sevoflurane /
- inhalation anesthesia
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[1] 高艳,郭欣欣,熊立红,等.I-gel喉罩在合并肺部疾病老年病人腹腔镜辅助阴式子宫切除术中的应用[J].中国临床医生杂志,2015,43(11):72. [2] PATEL CR,ENGINEER SR,SHAH BJ,et al.The effect of dexmedetomidine continuous infusion as an adjuvant to general anesthesia on sevoflurane requirements:a study based on entropy analysis[J].J Anaesthesiol Clin Pharmacol,2013,29(3):318. [3] 张利佳,吕洁萍,王鑫宇.丙泊酚与七氟醚对后腹腔镜手术病人凝血功能影响的比较[J].临床麻醉学杂志,2015,31(2):113. [4] 张艳杰,王俊莲,刘新蕊,等.低流量七氟醚用于腹腔镜手术麻醉的疗效及临床分析[J].安徽医药,2015,19(4):781. [5] 陈亮,李爱媛.腰-硬联合麻醉复合全麻对腹腔镜辅助下阴式子宫全切术病人麻醉效果及应激反应的影响[J].中国医师杂志,2015,17(3):422. [6] ORTIZ J,CHANG LC,TOLPIN DA,et al.Randomized,controlled trial comparing the effects of anesthesia with propofol,isoflurane,desflurane and sevoflurane on pain after laparoscopic cholecystectomy[J].Braz J Anesthesiol,2014,64(3):145. [7] 赵晓春,佟冬怡,龙波,等.右美托咪定对腹腔镜手术七氟醚用药量的影响[J].中国医科大学学报,2014,43(2):110. [8] 乐园,李杨,苏勋玲,等.BIS监测下丙泊酚靶控静脉麻醉与七氟醚麻醉效果比较[J].现代生物医学进展,2016,16(27):5380. [9] 杨晓瑞,葛静,周迪兰.七氟醚或丙泊酚复合瑞芬太尼麻醉在腹腔镜子宫切除术中的应用及对病人应激反应的影响[J].临床和实验医学杂志,2015,14(5):423. [10] DEEPAK TS,VADLAMANI S,KUMAR KS,et al.Post-operative cognitive functions after general anesthesia with sevoflurane and desflurane in South Asian elderly[J].Middle East J Anaesthesiol,2013,22(2):143. [11] 王伟,杨天德,王怡,等.静脉联合吸入麻醉在阴式子宫全切中的应用[J].热带医学杂志,2016,16(7):863. [12] 金娟新,王瑜,潘敏珠.不同剂量右美托咪复合地佐辛凯纷在子宫全切术后病人自控静脉镇痛中的对比[J].中国性科学,2016,25(1):44. [13] 蔡云亮,李安学,李文兵,等.七氟醚在不同麻醉深度下对老年腹腔镜手术病人术后认知功能的影响[J].海南医学,2015,26(11):1604. [14] DONNEZ O,DONNEZ J,DOLMANS MM,et al.Low pain score after total laparoscopic hysterectomy and same-day discharge within less than 5 hours:results of a prospective observational study[J].J Minim Invasive Gynecol,2015,22(7):1293. [15] 王娟,王涛,王昌合,等.腹腔镜手术应用喉罩时麻醉质量控制中术者积极参与的效果观察[J].蚌埠医学院学报,2016,41(6):736. -
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