瑞芬太尼复合丙泊酚麻醉在腹腔镜胆囊切除术治疗急性胆囊炎中的应用

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Abstract Objective To study the clinical effect of Remifentanil combined with Propofol anesthesia in patients undergoing laparoscopic cholecystectomy for acute cholecystitis and its influence on hemodynamic indexes.Methods A total of 124 patients with acute cholecystitis who received laparoscopic cholecystectomy in the Affiliated Central Hospital of Shenyang Medical College from June 2017 to June 2019 were selected as the research objects and divided into the observation group and the control group by random number table method,with 62 cases in each group.Patients in the control group received Remifentanil anesthesia while patients in the observation group received Remifentanil combined with Propofol anesthesia Anesthesia effect,anesthesia quality(sedation score[Ramsay score],motor nerve block score[Bromage score],awakening score[Steward score],visual analogue scale[VAS]score)and hemodynamic indexes(heart rate[HR],systolic blood pressure[SBP],diastolic blood pressure[DBP],left ventricular ejection fraction[LVEF],left ventricular end-diastolic blood pressure[LVEDd])were compared between the two groups.Results The excellent and good rate of anesthesia effect in the observation group(93.55%)was higher than that in the control group(83.87%),and the difference was statistically significant(P＜0.05).The Ramsay score,Bromage score and Steward score of the observation group were higher than those of the control group,and the VAS score was lower than that of the control group,the differences were statistically significant(P＜0.05).Before anesthesia induction,there were no statistically significant differences in hemodynamic indexes between the two groups(P＞0.05).After anesthesia induction,SBP,LVEF and LVEDd in observation group were lower than those before induction,HR,SBP,DBP,LVEF and LVEDd in control group were lower than those before anesthesia induction,and the differences were statistically significant(P＜0.05).After anesthesia,HR,SBP,DBP,LVEF and LVEDd of the two groups were lower than those before anesthesia induction,and the differences were statistically significant(P＜0.05).After operation,SBP,DBP and LVEDd in the observation group were lower than those before anesthesia induction,HR in the control group was higher than that before anesthesia induction,SBP,DBP,LVEF and LVEDd in the control group were lower than those before induction,and the differences were statistically significant(P＜0.05).After anesthesia induction and implementation,HR,SBP,DBP,LVEF and LVEDd in observation group were higher than those in control group,and the differences were statistically significant(P＜0.05).After surgery,SBP,DBP,LVEF and LVEDd in observation group were higher than those in control group,HR in observation group was lower than that in control group,and the difference was statistically significant(P＜0.05).Conclusion Remifentanil combined with Propofol anesthesia in the treatment of acute cholecystitis in laparoscopic cholecystectomy has good anesthetic effect,good quality of anesthesia for patients,postoperative recovery is also good,and the degree of hemodynamic changes in patients is smaller,the patient′s vital signs are more stable,and the safety is higher.

Key words： Remifentanil Propofol Laparoscopic cholecystectomy Acute cholecystitis Hemodynamics

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REN Nan-nan. Application of Remifentanil combined with Propofol anesthesia in laparoscopic cholecystectomy for acute cholecystitis[J]. 中国当代医药, 2021, 28(17): 148-151.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I17/148

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