不同麻醉方案对输尿管镜钬激光碎石术患者的效果评价

目的探讨不同麻醉方案对输尿管镜钬激光碎石术患者的效果。方法纳入2017年5月～2019年1月我院进行治疗的62例患者进行研究。依据随机对照原则分为两组,各31例。观察组实施瑞芬太尼静吸复合全麻插管。对照组实施硬膜外麻醉。观察麻醉相关指标、麻醉效果、麻醉时间指标。结果观察组麻醉起效时间为(4.36±0.49)min,麻醉药物使用剂量为(11.18±2.11)mL,术后排气时间为(3.07±0.87)h,住院时间为(3.59±0.75)d,对照组麻醉起效时间为(15.19±2.58)min,麻醉药物使用剂量为(22.86±3.54)mL,术后排气时间为(7.22±1.87)h,住院时间为(6.18±1.15)d。观察组麻醉起效时间快、所使用的麻醉药物剂量少、术后排气早,而且患者手术后的住院时间较短,两组对比,差异显著(P0.05)。观察组不良反应发生率为6.45%,无术后疼痛的情况发生,对照组不良反应发生率为29.03%,术后疼痛发生率为19.35%。观察组不良反应较少,患者术后疼痛轻,两组对比,差异显著(P0.05)。观察组麻醉感觉阻滞起效时间、运动阻滞起效时间、感觉阻滞平面固定时间均比较短,两组对比,差异显著(P0.05)。结论对进行输尿管镜钬激光碎石术的患者采取不同的麻醉方案,麻醉效果有差异,对比硬膜外麻醉,瑞芬太尼静吸复合全麻插管麻醉效果更有优势。

Effect of different anesthesia programs on anesthesia in patients undergoing ureteroscopic holmium laser lithotripsy

Objective To investigate the effect of different anesthesia regimens on anesthesia in patients undergoing ureteroscopic holmium laser lithotripsy.Methods A total of 62 patients who underwent treatment in our hospital from May 2017 to January 2019 were enrolled.According to the principle of randomized control,they were divided into two groups,with 31 cases in each group.The observation group was treated with remifentanil inhalation combined with general anesthesia intubation.The control group was subjected to epidural anesthesia.The anesthesia-related indicators,anesthesia effect,and anesthesia time indicators were observed.Results The onset time of anesthesia was (4.36±0.49) min,the dose of anesthetic was (11.18±2.11) mL,the postoperative exhaust time was (3.07±0.87)h,and the hospital stay was(3.59±0.75)d in the observation group.The anesthetic effect time was (15.19±2.58) min,the dose of anesthetic drug was(22.86±3.54) mL,the postoperative exhaust time was (7.22±1.87) h,and the hospital stay was (6.18±1.15)d in the control group.In the observation group,the onset time of anesthesia was fast,the dose of anesthetic drug used was small,the postoperative exhaustion was early,and the hospitalization time after surgery was shorter.The difference between the two groups was significant (P<0.05).The incidence of adverse reactions in the observation group was 6.45%,and no postoperative pain occurred.The incidence of adverse reactions in the control group was 29.03%,and the incidence of postoperative pain was 19.35%.There were fewer adverse reactions in the observation group,and the postoperative pain was lighter in the patients.The difference between the two groups was significant(P<0.05).The onset time of anesthesia sensory block,the onset time of exercise block,and the fixed time of sensory block were all shorter in the observation group.The difference between the two groups was significant (P<0.05).Conclusion Different anesthesia regimens used in patients undergoing ureteroscopic holmium laser lithotripsy have different anesthetic effects.Compared with epidural anesthesia,remifentanil combined with general anesthesia is more advantageous.