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

doi:10.3877/cma.j.issn.1674-392X.2023.04.020

Abstract

Abstract:

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.

Key words: Combined intravenous and inhalation anesthesia, Total intravenous anesthesia, Elderly, Laparoscope, Herniorrhaphy, Cognitive function

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]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(04): 458-462.

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URL: https://zhshfbwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-392X.2023.04.020

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References 21

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组别	例数	性别[例(%)]		年龄(岁,±s)	体重指数(kg/m²,±s)	美国麻醉医师协会分级[例(%)]		疝类型[例(%)]
组别	例数	男	女	年龄(岁,±s)	体重指数(kg/m²,±s)	Ⅰ级	Ⅱ级	斜疝	直疝
观察组	48	44(91.67)	4( 8.33)	63.25±7.44	26.47±1.24	16(33.33)	32(66.67)	40(83.33)	8(16.67)
对照组	48	42(87.50)	6(12.50)	62.90±7.23	26.84±1.33	19(39.58)	29(60.42)	41(85.42)	7(14.58)
t/χ²		0.447		0.234	1.410	0.405		0.079
P		0.504		0.815	0.162	0.525		0.779
组别	例数	受教育程度[例(%)]			基础疾病[例(%)]				手术时间(min,±s)
组别	例数	文盲	小学	初中及以上	糖尿病	高脂血症	高血压	冠心病	手术时间(min,±s)
观察组	48	3( 6.25)	28(58.33)	17(35.42)	21(43.75)	15(31.25)	17(35.42)	10(20.83)	66.68±12.32
对照组	48	5(10.42)	30(62.50)	13(27.08)	24(50.00)	13(27.08)	21(43.75)	14(29.17)	65.37±13.01
t/χ²		1.102			0.377	0.202	0.697	0.889	0.468
P		0.576			0.540	0.654	0.404	0.344	0.641

组别	例数	性别[例(%)]		年龄(岁,±s)	体重指数(kg/m²,±s)	美国麻醉医师协会分级[例(%)]		疝类型[例(%)]
组别	例数	男	女	年龄(岁,±s)	体重指数(kg/m²,±s)	Ⅰ级	Ⅱ级	斜疝	直疝
观察组	48	44(91.67)	4( 8.33)	63.25±7.44	26.47±1.24	16(33.33)	32(66.67)	40(83.33)	8(16.67)
对照组	48	42(87.50)	6(12.50)	62.90±7.23	26.84±1.33	19(39.58)	29(60.42)	41(85.42)	7(14.58)
t/χ²		0.447		0.234	1.410	0.405		0.079
P		0.504		0.815	0.162	0.525		0.779
组别	例数	受教育程度[例(%)]			基础疾病[例(%)]				手术时间(min,±s)
组别	例数	文盲	小学	初中及以上	糖尿病	高脂血症	高血压	冠心病	手术时间(min,±s)
观察组	48	3( 6.25)	28(58.33)	17(35.42)	21(43.75)	15(31.25)	17(35.42)	10(20.83)	66.68±12.32
对照组	48	5(10.42)	30(62.50)	13(27.08)	24(50.00)	13(27.08)	21(43.75)	14(29.17)	65.37±13.01
t/χ²		1.102			0.377	0.202	0.697	0.889	0.468
P		0.576			0.540	0.654	0.404	0.344	0.641

组别	例数	苏醒时间(min)	拔管时间(min)	离开手术室时间(min)	拔管时Steward苏醒评分(分)
观察组	48	6.21±1.51	9.78±1.76	18.08±4.23	4.75±0.42
对照组	48	7.67±1.62	11.55±2.45	21.84±4.89	4.21±0.53
t		4.657	4.065	4.029	5.532
P		<0.001	<0.001	<0.001	<0.001

组别	例数	苏醒时间(min)	拔管时间(min)	离开手术室时间(min)	拔管时Steward苏醒评分(分)
观察组	48	6.21±1.51	9.78±1.76	18.08±4.23	4.75±0.42
对照组	48	7.67±1.62	11.55±2.45	21.84±4.89	4.21±0.53
t		4.657	4.065	4.029	5.532
P		<0.001	<0.001	<0.001	<0.001

组别	例数	平均动脉压(mmHg)				心率(次/min)
组别	例数	T0	T1	T2	T3	T0	T1	T2	T3
观察组	48	83.82±7.14	86.29±5.18	92.54±6.64	89.31±5.37	81.45±6.78	85.58±7.49	90.65±6.24	87.59±7.42
对照组	48	82.71±6.09	90.89±6.86	97.16±5.20	94.01±5.35	80.80±7.33	89.42±8.80	94.20±6.92	90.85±7.89
t		0.081	3.707	3.795	4.296	0.451	2.302	2.640	2.085
P		0.935	<0.001	<0.001	<0.001	0.653	0.023	0.001	0.039

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