目的: 探究舒芬太尼复合七氟烷吸入运用咽气道流线型（streamlined liner of pharynx airway,SLIPA）喉罩对腹腔镜胆总管切开取石术患者麻醉镇痛、血流动力学的影响。方法: 收集2022年1月—2023年6月于我院进行腹腔镜胆总管切开取石术治疗的116例患者纳入研究。使用信封法将患者随机分为联合组和常规组,两组各58例。常规组接受舒芬太尼+丙泊酚麻醉,联合组在常规组基础上复合七氟烷吸入SLIPA喉罩麻醉。对比两组患者不同时间点的心率（HR）、平均动脉压（MAP）、脑电双频指数（BIS）,记录两组患者术后疼痛反应[模拟视觉评分量表（VAS）]、镇静程度[警觉/镇静清醒指数（OAAS）]以及麻醉不良反应发生率。结果: 联合组患者T1、T2、T3、T4时间点的HR水平均低于常规组;联合组患者T1、T2、T3、T4时间点的MAP水平均高于常规组;两组患者各时间点的BIS水平无显著差异;联合组术后12 h、24 h静息状态和活动状态下的VAS评分均低于常规组;联合组术后12 h、24 h的OAAS评分均高于常规组;联合组不良反应发生率低于常规组。结论: 腹腔镜胆总管切开取石术患者运用舒芬太尼复合七氟烷吸入运用SLIPA喉罩麻醉能有效稳定手术期间患者的血流动力学,缓解术后躁动,增强镇痛效果。
Abstract
Objective To explore the effects of streamlined liner of pharynx airway (SLIPA) laryngeal mask with sufentanil and sevoflurane inhalation on anaesthetic analgesia and hemodynamics in patients after laparoscopic common bile duct exploration. Methods A total of 116 patients undergoing laparoscopic common bile duct exploration in the hospital were enrolled between January 2022 and June 2023. According to envelope method, they were randomly divided into combination group and routine group, 58 cases in each group. The routine group was given sufentanil and propofol for anesthesia maintenance, while combination group was given sevoflurane inhalation for SLIPA laryngeal mask anesthesia on basis of routine group. The heart rate (HR), mean arterial pressure (MAP) and bispectral index (BIS) in the two groups were compared at different time points. The postoperative pain response [visual analogue scale (VAS) ], sedation degree [observer’s assessment of alertness/sedation (OAAS) ] and incidence of adverse anesthesia reactions in the two groups were recorded. Results At T1, T2, T3 and T4, HR in combination group was lower than that in routine group, MAP was higher than than that in routine group, but there was no significant difference in BIS between the two groups. At 12h and 24h after surgery, VAS scores under resting and motion states in combination group were lower than those in routine group, and OAAS scores were higher than those in routine group. The incidence of adverse reactions in combination group was lower than that in routine group. Conclusion Sufentanil combined sevoflurane inhalation for SLIPA laryngeal mask anesthesia can effectively stabilize hemodynamics, relieve postoperative agitation and enhance analgesia effect in patients during laparoscopic common bile duct exploration.
关键词
舒芬太尼 /
七氟烷 /
咽气道流线型喉罩 /
麻醉镇痛 /
血流动力学
Key words
sufentanil /
sevoflurane /
streamlined liner of pharynx airway laryngeal mask /
anaesthetic analgesia /
hemodynamics
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基金
河北省卫生健康委员会项目“恩沙替尼联合放化疗治疗晚期非小细胞肺癌临床研究”（20241481）
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