摘要
目的 探讨环泊酚或丙泊酚静脉麻醉对腹腔镜下胆囊切除(LC)日间手术患者术后恢复质量的影响.方法 133例LC日间手术患者采用环泊酚静脉麻醉(C组,n=65)和丙泊酚静脉麻醉(P组,n=68),收集2组患者的性别、年龄、身高、体质量、体质量指数(BMI)、文化程度及美国麻醉医师协会(ASA)分级等一般资料,记录麻醉诱导前(T0)、给药后1 min(T1)、气管插管后即刻(T2)、手术开始时(T3)、手术结束时(T4)、拔管后即刻(T5)及出麻醉后恢复室(PACU)时(T6)的平均动脉压(MAP)、心率(HR)及脉搏氧饱和度(SpO2),记录手术时间、麻醉时间、拔管时间等手术、麻醉与苏醒恢复相关指标;采用15项恢复质量量表(QoR-15)评价2组患者术前及术后24h、72h的恢复质量,记录围手术期低血压、高血压及心动过缓等不良事件.结果 2组患者术后24 h QoR-15评分总分的95％置信区间为(-2.10,1.03),其下限大于非劣效界值-8;与P组相比,C组患者拔管时间延长(P＜0.05);T1、T3和T4时点同组患者MAP和HR均较T0时点降低(P＜0.05),T2时点同组患者MAP和HR均较T1时点升高(P＜0.05),T1～T5时点同组患者SpO2均较T0时点升高(P＜0.05),T6时点患者SpO2较T1时点降低(P＜0.05);与P组相比,C组患者注射痛发生率明显降低(P＜0.01).结论 环泊酚或丙泊酚静脉麻醉对LC日间手术患者术后恢复质量影响无差别,环泊酚静脉麻醉注射痛发生率低.
Abstract
Objective To investigate the effect of intravenous anesthesia with ciprofol and propofol on postoperative recovery quality in patients after daytime laparoscopic cholecystectomy(LC).Methods A total of 133 patients with daytime LC were divided into the ciprofol group(group C,n=65)and the propofol group(group P,n=68).General clinical data including gender,age,height,weight,body mass index(BMI),educational level and American Society of Anesthesiologists(ASA)physical status classification system of the two groups were collected.Mean arterial pressure(MAP),heart rate(HR),and pulse oxygen saturation(SpO2)were recorded before induction(T0),1 minute after administration(T1),immediately after endotracheal intubation(T2),in the beginning of surgery(T3),in the end of surgery(T4),immediately after extubation(T5),and at the time of exit from the post-anesthesia care unit(PACU,T6).Operation time,anesthesia time,extubation time and other relevant indexes of operation,anesthesia and recovery were recorded in the 2 groups.The 15-item quality of recovery scale(QoR-15)was used to evaluate the recovery quality of the 2 groups before surgery,24 hours and 72 hours after surgery.Perioperative adverse events(hypotension,hypertension,bradycardia,tachycardia,postoperative nausea and vomiting,injection pain)were recorded in 2 groups.Results The 95％confidence interval of the total score of QoR-15 in 2 groups 24 h after surgery was(-2.01,1.03),and the lower limit of 95％confidence interval was greater than the non-inferiority margin of-8.Compared with group P,the extubation time was longer than that in group C(P＜0.05).MAP and HR of the patients at T1,T3,and T4were reduced more than those at T0(P＜0.05),and were elevated at T2 compared with those at T1 in the same group(P＜0.05).SpO2 of the patients were elevated at T,-T5 compared with those at T0,in the same group(P＜0.05).SpO2 of the patients at T6 decreased compared with that at T1 in the same group(P＜0.05).Compared with group P,the incidence of injection pain in group C was significantly lower(P＜0.01).Conclusion Total intravenous anesthesia based on ciprofol and propofol has no difference in the postoperative recovery quality of patients with daytime LC.Intravenous anesthesia with ciprofol has a low incidence of injection pain.
基金项目
贵州医科大学麻醉与疼痛研究重点实验室建设项目([2024]fy003)
NETL
NSTL
万方数据