Anesthetic effect comparison of Sevoflurane inhalation anesthesia with Propofol intravenous anesthesia in elderly patients undergoing laparoscopic cholecystectomy
LI Jun-shi
Department of Anesthesiology, Changxing Branch, the Second Affiliated Hospital of Zhejiang University School of Medicine (Changxing People′s Hospital), Zhejiang Proxince, Changxing 313100, China
摘要目的 探讨七氟醚吸入麻醉与丙泊酚静脉麻醉对老年腹腔镜胆囊切除患者的麻醉效果比较。方法 选取2018年2月～2019年2月我院的100 例老年腹腔镜胆囊切除患者作为研究对象，采用随机数字表法将其分为对照组（50 例）与研究组（50 例）。 对照组患者采用丙泊酚静脉麻醉，研究组患者采用七氟醚吸入麻醉。 比较两组患者的麻醉效果；比较两组患者的术后麻醉苏醒、拔管及恢复时间；比较两组患者术后不同时间段的简易智力状态检查量表（MMSE）评分；比较两组患者术后不同时间段的视觉模拟量表（VAS）评分。结果 研究组患者的麻醉优良率为98.00%，高于对照组（76.00%），差异有统计学意义（P＜0.05）；研究组患者的术后麻醉苏醒时间为（16.85±3.05）min，术后拔管时间为（23.50±3.80）min，术后恢复时间为（23.65±4.70）min，均短于对照组[（20.65±3.55）、（27.85±4.65）、（27.95±4.80）min]，差异有统计学意义（P＜0.05）；研究组患者术后1 h 的MMSE 评分为（28.35±0.35）分，术后4 h 的MMSE 评分为（27.45±1.25）分，术后12 h 的MMSE 评分为（27.85±1.15）分，均高于对照组[（22.95±2.50）、（23.85±1.40）、（25.95±1.20）分]，差异有统计学意义（P＜0.05）；研究组患者术后24、48 h 的MMSE 评分与对照组比较，差异无统计学意义（P＞0.05）；研究组患者术后1 h 的VAS 评分为（1.25±0.40）分，术后4 h 的VAS 评分为（2.15±0.55）分，术后12 h 的VAS 评分为（2.15±0.45）分，术后24 h 的VAS 评分为（1.88±0.60）分，术后48 h 的VAS 评分为（1.45±0.55）分，与对照组[（1.23±0.45）、（2.09±0.60）、（2.19±0.40）、（1.93±0.55）分、（1.48±0.50）分]比较，差异无统计学意义（P＞0.05）。 结论 与丙泊酚静脉麻醉比较，对老年腹腔镜胆囊切除患者实施七氟醚吸入麻醉的效果显著。
Abstract：Objective To compare the anesthetic effect of Sevoflurane inhalation anesthesia and Propofol intravenous anesthesia in elderly patients with laparoscopic cholecystectomy. Methods A total of 100 elderly patients undergoing laparoscopic cholecystectomy in our hospital from February 2018 to February 2019 were selected as the research subjects, and they were divided into control group (n=50) and research group (n=50) by random number table method. Patients in the control group were provided with Propofol anesthesia, and patients in the research group were anesthetized with inhalation of Sevoflurane. The anesthetic effect of the two groups were compared. The postoperative anaesthesia recovery, extubation and recovery time of the two groups were compared. The mini-mental state examination scale(MMSE) scores of the two groups were compared at different time points after operation. Visual analogue scale (VAS)scores were compared between the two groups at different time points after surgery. Results The excellent anesthesia rate of patients in the research group was 98.00%, which was higher than that in the control group (76.00%), the difference was statistically significant (P＜0.05). The postoperative anesthesia recovery time of patients in the research group was (16.85±3.05) min, the post-extubation time was (23.50±3.80) min, and the post-operative recovery time was(23.65±4.70) min, which were shorter than those of the control group ([20.65±3.55], [27.85±4.65], [27.95±4.80] min),the differences were statistically significant (P＜0.05). The MMSE score at 1 h postoperatively of the patients in the research group was (28.35±0.35) points, the MMSE score at 4 h postoperatively was (27.45±1.25) points, and the MMSE score at 12 h postoperatively was (27.85±1.15) points, which were higher than those in the control group ([22.95±2.50],[23.85±1.40], [25.95±1.20] points), the differences were statistically significant (P＜0.05). There was no significant difference in MMSE scores between the research group and the control group at 24 and 48 h postoperatively (P＞0.05). In the research group, the VAS score score at 1 h postoperatively was (1.25±0.40) points, the VAS score score at 4 h postoperatively was (2.15±0.55) points, the VAS score score at 12 h postoperatively was (2.15±0.45) points, the VAS score score at 24 h postoperatively was (1.88±0.60) points, and the VAS score score at 48 h postoperatively was (1.45±0.55) points, which were not displayed statistical significance compared with the control group ([1.23±0.45], [2.09±0.60], [2.19±0.40], [1.93±0.55], [1.48±0.50] points), respectively (P＞0.05). Conclusion Compared with Propofol intravenous anesthesia, the effect of Sevoflurane inhalation anesthesia in elderly patients undergoing laparoscopic cholecystectomy is remarkable.
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