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全身麻醉复合腰硬联合麻醉对腹腔镜手术患者术后的影响
作者姓名:李清  朱燕琴  陈林
作者单位:福州市第一医院麻醉科
摘    要:目的 通过研究探讨全身麻醉复合腰硬联合麻醉对腹腔镜手术患者术后疼痛程度与麻醉复苏时间的影响,为该手术的麻醉方法选择提供可依靠的依据。方法 选取医院从2019年1月—2020年10月在医院进行腹腔镜手术的患者98例,随机分成两组。其中对照组采用丙泊酚与瑞芬太尼靶控静脉麻醉,观察组患者则在对照组基础上复合使用腰硬联合麻醉的方法进行麻醉,对比两组患者手术后的疼痛程度(visual analogue scale,VAS)评分、苏醒质量以及两组患者手术前后的简易精神状态评价量表(minimental state examination,MMSE)评分、警觉-镇静评分(the observer’s assessment of alertness/sedation scale,OAAS)。结果 两组患者经过相应的麻醉手术后在拔管时间、苏醒时间的数据上差异无统计学意义(P> 0.05);而观察组患者在自主恢复呼吸时间以及定向力恢复时间上明显的短于对照组患者,与对照组患者具有差异,差异有统计学意义(P <0.05);两组患者的拔管1 h、3 h MMSE评分、VAS评分、警觉-镇静评分(OA...

关 键 词:丙泊酚  瑞芬太尼  腰硬联合麻醉  腹腔镜手术  认知功能  疼痛程度

Effects of General Anesthesia Combined With Spinal-epidural Anesthesia on Patients Undergoing Laparoscopic Surgery
Authors:LI Qing  ZHU Yanqin  CHEN Lin
Institution:(Department of Anesthesiology,Fuzhou First Hospital,Fuzhou Fujian 350000,China)
Abstract:Objective To investigate the effects of general anesthesia combined with combined spinal-epidural anesthesia on postoperative pain and anesthesia recovery time of patients undergoing laparoscopic surgery, and to provide a reliable basis for the selection of anesthesia methods for this operation. Methods A total of 98 patients requiring laparoscopic surgery who were admitted to our hospital from January 2019 to October 2020 were selected and divided into observation group 49 cases and control group 49 cases by random number method. The control group was used propofol and remifentanil target-controlled intravenous anesthesia, and the observation group was anesthetized with combined spinal-epidural anesthesia on the basis of the control group. The pain levels of the two groups after surgery were compared visual analogue scale(VAS) score, quality of resuscitation, mini-mental state examination(MMSE) score before and after surgery, and the observer’s assessment of alertness/sedation scale(OAAS). Results There was no significant difference in the data of the extubation time and resuscitation time between the two groups of patients after the corresponding anesthesia operation, and the difference was not statistically significant(P > 0.05);while the observation group patients in the recovery spontaneous breathing time and orientation recovery time was significantly shorter than that of the control group, and the difference was statistically significant(P < 0.05);the 1 h, 3 h after extubation MMSE score, VAS score, and alertness-sedation score(OAAS) of the two groups were different, and the difference was statistically significant(P < 0.05).The observation group was better than the control group. Conclusion General anesthesia combined with combined spinal-epidural anesthesia has the advantages of short recovery time, less impact on patients’ cognitive function, and low pain for patients undergoing laparoscopic surgery. It is worthy of clinical application.
Keywords:propofol  remifentanil  combined spinal-epidural anesthesia  laparoscopic surgery  cognitive function  pain degree
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