摘要
目的:探讨妇科腹腔镜手术丙泊酚复合艾司氯胺酮麻醉对患者血流动力学及苏醒质量的影响。方法:将2021年1月-2023年1月在本院妇科收治的100例腹腔镜手术患者随机分成对照组与观察组各50例,均行全麻,对照组采取丙泊酚麻醉诱导,观察组采用丙泊酚复合艾司氯胺酮麻醉诱导,其他麻醉方法相同。观察麻醉诱导前(T0)、气管插管后5min(T1)、建立二氧化碳气腹后30min(T2)、关闭二氧化碳气腹后5min(T4)血流动力学、苏醒质量、炎性因子水平以及不良反应。结果:T1~T3两组平均动脉压、心率均降低但观察组高于对照组;观察组自主呼吸恢复时间(2.26±1.02 min)、呼之睁眼时间(5.53±1.38 min)、定向力恢复时间(6.56±1.49 min)均短于对照组(4.15±1.19 min、7.11±1.55 min、8.54±2.01 min);术后1d两组血清白介素-6、肿瘤坏死因子-α水平均升高但观察组(148.78±24.92 ng/L、26.16±5.63 ng/L)低于对照组(213.83±32.43 ng/L、33.28±6.45 ng/L);不良反应发生率观察组(6.0%)低于对照组(20.0%)(均P<0.05)。结论:妇科腹腔镜手术丙泊酚复合艾司氯胺酮麻醉效果较好,可稳定患者血流动力学指标,提高苏醒质量,减轻炎症反应,不良反应少。
Objective:To investigate the effects of propofol combined with esketamine used during gynecological laparoscopic surgery of patients on their hemodynamics and quality of awaken.Methods:From January 2021to January 2023,100patients who wanted gynecological laparoscopic surgery were selected and were randomly divided into two groups(50cases in each group).The patients in the two groups were given general anesthesia during surgery.The patients in the observation group had received anesthesia induction with propofol combined with esketamine.The patients in the control group had received anesthesia induction with propofol.Other anesthesia methods for the patients in the two groups were the same.The hemodynamics,the recovery quality,the inflammatory factors,and the adverse reactions of the patients in the two groups before anesthesia induction(T0),at 5min after tracheal intubation(T1),at 30 min after carbon dioxide pneumoperitoneum establishment(T2),and at 5min after carbon dioxide pneumoperitoneum closure(T4)were observed.Results:The values of mean arterial pressure and heart rate of the patients in the two groups at T1-T3had decreased significantly,but which of the patients in the observation group were significantly higher than those of the patients in the control group.The recovery time of spontaneous breathing(2.26±1.02min),the time of opening eyes(5.53±1.38min),and the recovery time of orientation(6.56±1.49min)of the patients in the observation group were significantly shorter than those(4.15±1.19min,7.11±1.55min,and 8.54±2.01min)of the patients in the control group.The levels of serum interleukin-6and tumor necrosis factor?αof the patients in the two groups on the first day after operation had increased significantly,but which(148.78±24.92ng/L and 26.16±5.63 ng/L)of the patients in the observation group were significantly lower than those(213.83±32.43ng/L and 33.28±6.45ng/L)of the patients in the control group.The incidence of the adverse reactions(6.0%)of the patients in the observation group was sign
作者
常丽丽
吴炤霖
CHANG Lili;WU Zhaolin(The First People's Hospital of Wuyi County,Jinhua,Zhejiang Province,321200;Jinhua Central Hospital of Zhejiang)
出处
《中国计划生育学杂志》
2023年第12期2870-2873,2878,共5页
Chinese Journal of Family Planning
关键词
妇科腹腔镜手术
丙泊酚
艾司氯胺酮
血流动力学
苏醒质量
炎症因子
Gynecological laparoscopic surgery
Propofol
Esketamine
Hemodynamics
Quality of awaken
Inflammatory factor
