摘要
目的分析瑞芬太尼复合七氟烷在全麻下脊柱手术中的应用效果。方法收集2022年1月至2023年6月于河南省荣军医院全麻下脊柱手术中给予瑞芬太尼复合丙泊酚麻醉维持的48例患者病历资料,纳入对照组;收集同期医院全麻下脊柱手术中给予瑞芬太尼复合七氟烷麻醉维持的48例患者病历资料,纳入观察组;全部患者临床资料均保存完整。对比两组镇痛、镇静效果和不同时点[麻醉前(T_(0))、插管前(T_(1))、插管后5 min(T _(2))、术毕(T_(3))]血流动力学指标、恢复效果;对比两组术后不良反应。结果观察组镇静满意度与对照组相比,差异无统计学意义(P>0.05)。观察组术后4、6、12、24 h视觉模拟评分法(VAS)评分较对照组低(P<0.05)。两组T_(1)、T_(2)、T_(3)时平均动脉压、心率较术前下降,但观察组较对照组高(P<0.05);组间各时点心率和平均动脉压比较,差异无统计学意义(P>0.05)。观察组患者定向力恢复时间、呼吸恢复时间、拔管时间、苏醒时间短于对照组(P<0.05);两组患者术后不良反应发生率比较,差异无统计学意义(P>0.05)。结论瑞芬太尼复合七氟烷在全麻下脊柱手术中具有较好的镇静效果和镇痛效果,可维持稳定的血流动力学水平,有助患者术后麻醉恢复,且安全性尚可。
Objective To analyze the application effect of remifentanil combined with sevoflurane in spinal surgery under general anesthesia.Methods Medical records of 48 patients who underwent spinal surgery under general anesthesia at Henan Province Veterans Hospital from January 2022 to June 2023 were collected and included in the control group.Medical records of 48 patients who received remifentanil combined with sevoflurane anesthesia for spinal surgery under general anesthesia in the same hospital during the same period were collected and included them in the observation group.All clinical data of patients had been fully preserved.The analgesic and sedative effects,hemodynamic indexes and recovery effects at different time points[before anesthesia(T_(0)),before intubation(T_(1)),5 min after intubation(T_(2)),and at the end of operation(T 3)]of both groups were compared.The postoperative adverse reactions were compared in both groups.Results The difference was not statistically significant in sedation satisfaction between observation group and control group(P>0.05).Compared with control group,the visual analogue scale(VAS)scores of the observation group were lower at 4,6,12,and 24 hours after surgery(P<0.05).The mean arterial pressure and heart rate at T_(1),T_(2) and T_(3) in the two groups were lower than those before operation,but the observation group was higher than the control group(P<0.05).There was no differences in heart rate and mean arterial pressure at each time point between the two groups(P>0.05).Compared with control group,the recovery time of directional force,respiratory recovery time,extubation time,and awakening time of the observation group patients were shorter(P<0.05).There were no differences in the incidence of postoperative adverse reactions between the two groups of patients(P>0.05).Conclusion Remifentanil combined with sevoflurane has good sedative and analgesic effects in spinal surgery under general anesthesia,can maintain stable hemodynamic levels,help patients recover from postoperative anesthesia,and is safe.
作者
周江生
靳珂
赵艳芳
ZHOU Jiangsheng;JIN Ke;ZHAO Yanfang(Department of Anesthesiology,Henan Province Veterans Hospital,Xinxiang 453000,China)
出处
《河南医学研究》
CAS
2024年第23期4305-4309,共5页
Henan Medical Research
关键词
脊柱手术
瑞芬太尼
七氟烷
丙泊酚
麻醉维持
麻醉效果
spinal surgery
remifentanil
sevoflurane
propofol
anesthesia maintenance
anesthetic effect
