七氟烷联合瑞芬太尼麻醉对老年腹腔镜疝修补术患者苏醒质量的影响

目的探讨七氟烷联合瑞芬太尼麻醉对老年腹腔镜疝修补术患者苏醒质量的影响。 方法选择2018年1月至2020年3月于公安县人民医院接受腹腔镜疝修补术的86例老年患者作为研究对象，按照随机编号法分为观察组和对照组，每组43例。对照组患者手术过程中进行瑞芬太尼麻醉，观察组给予七氟烷联合瑞芬太尼麻醉。比较2组患者手术过程中血流动力学指标的变化、麻醉相关指标、苏醒质量评分及术后不良反应率。 结果2组患者麻醉诱导时血氧饱和度（SpO₂）、心率（HR）、平均动脉压（MAP）无明显差异（P>0.05）；手术后即刻2组患者血流动力学指标MAP、HR均升高，SpO₂均下降，且观察组上述指标的波动幅度明显低于对照组（P<0.05）。观察组患者恢复自主呼吸时间、睁眼时间、指令反应时间、拔管时间均低于对照组，差异均有统计学意义（P均<0.05）；2组患者拔管后苏醒质量评分的组间效应及苏醒质量评分的时间效应比较，差异均有统计学意义（P均<0.05）；2组患者苏醒质量评分的麻醉方法与时间因素均存在交互作用（P<0.05）；观察组术后不良情况发生率为11.63%显著低于对照组30.23%，差异有统计学意义（P<0.05）。 结论七氟烷联合瑞芬太尼麻醉应用于老年腹腔镜疝修补术，患者术中血流动力学平稳，苏醒更快，拔管时间更短，降低术后患者并发症的发生率。

Effect of sevoflurane combined with remifentanil anesthesia on recovery quality of elderly patients undergoing laparoscopic hernia repair

ObjectiveTo investigate the effect of sevoflurane combined with remifentanil anesthesia on recovery quality of elderly patients undergoing laparoscopic hernia repair. Methods86 elderly patients who underwent laparoscopic hernia repair in People's Hospital of Gong'an County between January 2018 and March 2020 were selected as the study subjects. They were randomly divided into observation group and control group by the random numbering method, with 43 cases in each group. The control group were anesthetized with remifentanil during operation, and the observation group were anesthetized with sevoflurane combined with remifentanil. The changes in hemodynamic indexes, anesthesia related indexes, recovery quality scores and incidence of postoperative adverse reactions were compared between the two groups. ResultsThere was no significant difference in blood oxygen saturation (SpO₂), heart rate (HR) or mean arterial pressure (MAP) between the two groups during anesthesia induction (P>0.05). The MAP and HR of both groups increased, while SpO₂ decreased immediately after surgery, and the fluctuation range of the above indexes in the observation group was significantly lower than that in the control group (P<0.05). The recovery time of spontaneous breathing, eye opening time, command response time and extubation time in the observation group were shorter than those in the control group (P<0.05). The differences in recovery quality scores after extubation were statistically significant between two groups and at different time (P<0.05), and there was an interactive effect between anesthesia methods and time in terms of the recovery quality scores (P<0.05). The incidence rate of postoperative adverse reactions in the observation group (11.63%) was significantly lower than that in the control group (30.23%; P<0.05). ConclusionThe application of sevoflurane combined with remifentanil anesthesia in elderly laparoscopic hernia repair has stable hemodynamics during operation, with faster recovery and shorter extubation time, and can reduce incidence of postoperative complications.