摘要
目的 通过研究探讨全身麻醉复合腰硬联合麻醉对腹腔镜手术患者术后疼痛程度与麻醉复苏时间的影响,为该手术的麻醉方法选择提供可依靠的依据。方法 选取医院从2019年1月—2020年10月在医院进行腹腔镜手术的患者98例,随机分成两组。其中对照组采用丙泊酚与瑞芬太尼靶控静脉麻醉,观察组患者则在对照组基础上复合使用腰硬联合麻醉的方法进行麻醉,对比两组患者手术后的疼痛程度(visual analogue scale,VAS)评分、苏醒质量以及两组患者手术前后的简易精神状态评价量表(minimental state examination,MMSE)评分、警觉-镇静评分(the observer’s assessment of alertness/sedation scale,OAAS)。结果 两组患者经过相应的麻醉手术后在拔管时间、苏醒时间的数据上差异无统计学意义(P> 0.05);而观察组患者在自主恢复呼吸时间以及定向力恢复时间上明显的短于对照组患者,与对照组患者具有差异,差异有统计学意义(P <0.05);两组患者的拔管1 h、3 h MMSE评分、VAS评分、警觉-镇静评分(OAAS)差异有统计学意义(P <0.05)。观察组均优于对照组。结论 全身麻醉复合腰硬联合麻醉对腹腔镜手术患者具有恢复时间短、对患者认知功能影响小、疼痛程度低等优势,值得临床推广使用。
Objective To investigate the effects of general anesthesia combined with combined spinal-epidural anesthesia on postoperative pain and anesthesia recovery time of patients undergoing laparoscopic surgery, and to provide a reliable basis for the selection of anesthesia methods for this operation. Methods A total of 98 patients requiring laparoscopic surgery who were admitted to our hospital from January 2019 to October 2020 were selected and divided into observation group 49 cases and control group 49 cases by random number method. The control group was used propofol and remifentanil target-controlled intravenous anesthesia, and the observation group was anesthetized with combined spinal-epidural anesthesia on the basis of the control group. The pain levels of the two groups after surgery were compared visual analogue scale(VAS) score, quality of resuscitation, mini-mental state examination(MMSE) score before and after surgery, and the observer’s assessment of alertness/sedation scale(OAAS). Results There was no significant difference in the data of the extubation time and resuscitation time between the two groups of patients after the corresponding anesthesia operation, and the difference was not statistically significant(P > 0.05);while the observation group patients in the recovery spontaneous breathing time and orientation recovery time was significantly shorter than that of the control group, and the difference was statistically significant(P < 0.05);the 1 h, 3 h after extubation MMSE score, VAS score, and alertness-sedation score(OAAS) of the two groups were different, and the difference was statistically significant(P < 0.05).The observation group was better than the control group. Conclusion General anesthesia combined with combined spinal-epidural anesthesia has the advantages of short recovery time, less impact on patients’ cognitive function, and low pain for patients undergoing laparoscopic surgery. It is worthy of clinical application.
作者
李清
朱燕琴
陈林
LI Qing;ZHU Yanqin;CHEN Lin(Department of Anesthesiology,Fuzhou First Hospital,Fuzhou Fujian 350000,China)
出处
《中国卫生标准管理》
2022年第5期55-58,共4页
China Health Standard Management
关键词
丙泊酚
瑞芬太尼
腰硬联合麻醉
腹腔镜手术
认知功能
疼痛程度
propofol
remifentanil
combined spinal-epidural anesthesia
laparoscopic surgery
cognitive function
pain degree
