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中华疝和腹壁外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (04) : 458 -462. doi: 10.3877/cma.j.issn.1674-392X.2023.04.020

论著

静脉-吸入复合麻醉与全静脉麻醉在老年腹腔镜疝修补术中应用效果比较
李大伟(), 吴宏飞, 韩鹏, 孙盼盼, 邢红伟   
  1. 236400 安徽省,临泉县人民医院麻醉科
    236400 安徽省,临泉县人民医院神经外科
  • 收稿日期:2023-04-23 出版日期:2023-08-18
  • 通信作者: 李大伟
  • 基金资助:
    阜阳市卫健委科研立项项目(FY2019-114)

Comparative effect of static aspiration compound anesthesia and all-right intravenous anesthesia in geriatric laparoscopic hernia repair

Dawei Li(), Hongfei Wu, Peng Han, Panpan Sun, Hongwei Xing   

  1. Anesthesiology Department of Linquan County People's Hospital, Linquan 236400, Anhui Province, China
    Department of Neurosurgery, People's Hospital of Linquan County, Linquan 236400, Anhui Province, China
  • Received:2023-04-23 Published:2023-08-18
  • Corresponding author: Dawei Li
引用本文:

李大伟, 吴宏飞, 韩鹏, 孙盼盼, 邢红伟. 静脉-吸入复合麻醉与全静脉麻醉在老年腹腔镜疝修补术中应用效果比较[J/OL]. 中华疝和腹壁外科杂志(电子版), 2023, 17(04): 458-462.

Dawei Li, Hongfei Wu, Peng Han, Panpan Sun, Hongwei Xing. Comparative effect of static aspiration compound anesthesia and all-right intravenous anesthesia in geriatric laparoscopic hernia repair[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(04): 458-462.

目的

比较静脉-吸入复合麻醉(静吸复合麻醉)与全静脉麻醉在老年腹腔镜疝修补术中的效果。

方法

选取2019年8月至2021年8月,在临泉县人民医院接受腹腔镜疝修补术的96例老年患者,按照随机数字法分为观察组和对照组,各48例。观察组采取静吸复合麻醉,对照组采取全静脉麻醉。比较两组患者苏醒时间、拔管时间、离开手术室时间、拔管时Steward苏醒评分,麻醉诱导前(T0)、插管后(T1)、建立气腹后(T2)、手术结束时(T3)的平均动脉压、心率以及术前及术后1、3、5 d的简易精神状况检查量表(MMSE)评分,并统计两组不良反应发生率。

结果

观察组苏醒时间、拔管时间、离开手术室时间均显著短于对照组,拔管时Steward苏醒评分显著高于对照组(P<0.05);观察组T1~T3时刻的平均动脉压、心率均明显低于对照组(P<0.05);观察组术后1、3 d的MMSE评分明显低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。

结论

相较于全静脉麻醉,静吸复合麻醉可以更好地维持老年腹腔镜疝修补术患者的血流动力学稳定,提高复苏质量。但全静脉麻醉对改善术后早期认知功能障碍的效果优于静吸复合麻醉。

Objective

To compare the effect of static aspiration compound anesthesia with full intravenous anesthesia in elderly laparoscopic hernia repair.

Methods

The study subjects were 96 elderly patients undergoing laparoscopic hernia repair in our hospital from August 2019 to August 2021, who were divided into an observation group and a control group according to the random number method, with 48 cases in each group. The observation group takes static suction compound anesthesia, and the control group takes all intravenous anesthesia. Compare patients’ awake time, extubation time, leaving the operating room time, Steward score during extubation, and before anesthesia induction (T0), intubation (T1), establishing pneumoperitoneum (T2), operation end (T3) mean arterial pressure, heart rate, and preoperative and 1, 3, 5 d after operation mini-mental state examination (MMSE) scores, and the incidence of adverse reactions in 2 groups.

Results

The recovery time, extubation time, and leaving the operating room time in the observation group were significantly lower than the control group, and Steward score in the observation group was significantly higher than the control group (P<0.05); the mean arterial pressure and heart rate from T1 to T3 were significantly lower than the control group (P<0.05); the MMSE scores 1 d and 3 d after surgery were significantly lower than the control group (P<0.05); the incidence of adverse reactions in the two groups was not statistically significant (P>0.05).

Conclusion

Compared with intravenous anesthesia, static aspiration compound anesthesia can better maintain hemodynamic stability and improve resuscitation therapy in elderly patients with laparoscopic hernia repair. However, intravenous anesthesia is better at improving early postoperative cognitive dysfunction than static aspiration compound anesthesia.

表1 两组患者一般资料比较
表2 两组患者复苏质量指标比较(±s
表3 两组患者不同时刻的血流动力学指标水平比较(±s
表4 两组患者手术前后简易精神状况检查量表评分比较(±s
表5 两组患者不良反应发生率比较[例(%)]
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