Effect of Sevoflurane Inhalation Combined with Remifentanil Anesthesia on Cerebral Oxygen Metabolism and Awakening Quality in Patients Undergoing Laparoscopic Choledochotomy
Objective To investigate the effects of sevoflurane inhalation combined with remifentanil anesthesia on cerebral oxygen metabolism and postoperative awakening quality in patients undergoing laparoscopic choledochotomy.Methods Eighty-eight patients who underwent laparoscopic choledochotomy in Zhangdian District Hospital of Traditional Chinese Medicine of Zibo City from October 2022 to October 2023 were selected as the research objects,and were divided into a control group and an observation group according to random number table method.The control group(n=44)was anesthetised with propofol combined with remifentanil,and the observation group(n=44)was anesthetised with sevoflurane inhalation combined with remifentanil.The perioperative hemodynamics indicators,cerebral oxygen metabolism,postoperative awakening quality,postoperative pain,cognitive function and adverse reactions were compared between the two groups.Results Before anesthesia(T0),there were no differences in the mean arterial pressure(MAP),heart rate(HR)between the two groups(P＞0.05);after anesthesia(T1),30 min after pneumoperitoneum establishment(T2),and the end of the operation(T3),the MAP levels of the observation group were(66.91±3.34)mmHg(1 mmHg=0.133 kPa),(67.01±2.95)mmHg,(66.93±3.03)mmHg,respectively,which were lower than(69.09±3.18)mmHg,(70.11±3.32)mmHg,(68.75±4.13)mmHg of the control group,and the HR levels was(77.98±5.15)times/min,(78.96±9.53)times/min,(77.67±3.97)times/min,respectively,which were lower than(81.44±5.65)times/min,(85.94±3.93)times/min and(80.12±4.51)times/min of the control group,and the differences between the groups were statistically significant(P＜0.05).At T0,there was no significant difference in cerebral extraction of oxygen(CEO2)between the two groups(P＞0.05);at T1,T2 and T3,the CEO2 levels of the observation group were(30.18±6.36)%,(27.55±3.77)%and(29.64±5.08)%,respectively,which were lower than(34.14±6.07)%,(30.28±3.73)%and(33.09±4.56)%of the control group,the differences between the groups were statistically significant(P＜0.05).In the observation group,the postoperative eye opening time,speech response time,spontaneous respiration recovery time and extubation time were(9.95±2.67)min,(12.42±1.86)min,(3.53±0.69)min and(6.56±1.47)min,respectively,which were shorter than(11.83±2.58)min,(15.05±1.99)min,(5.05±0.77)min and(8.84±1.35)min in the control group,and the differences between the groups were statistically significant(P＜0.05).24 h after operation,the pain Visual Analogue Score of the observation group was(3.12±1.18)points,which was lower than(4.94±1.26)points of the control group,and the difference was statistically significant(P＜0.05).Before operation,there was no significant difference in the total score of Mini-Mental State Examination(MMSE)between the two groups(P＞0.05);24 h after operation,the total score of MMSE in the observation group was(27.11±1.14)points,which was higher than(25.05±1.16)points in the control group,and the difference was statistically significant(P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).Conclusion Sevoflurane inhalation combined with remifentanil anesthesia can stabilize hemodynamics indicators,improve cerebral oxygen metabolism,improve postoperative awakening quality,and alleviate postoperative pain and cognitive dysfunction in patients undergoing laparoscopic choledochotomy.
Laparoscopic choledochotomySevofluraneRemifentanilCerebral extraction of oxygenAwakening qualityCognitive function
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