Effect of Different Doses of Remifentanil Combined with Low-dose Esketamine on Patients Undergoing Laparoscopic Gynecological Surgery and Its Effect on Anesthesia Efficacy and Pain
Objective:To study the effect of different doses of remifentanil combined with low-dose esketamine on anesthesia in patients undergoing laparoscopic gynecological surgery.Methods:A total of 60 patients who underwent laparoscopic gynecological surgery in our hospital from April 2020 to February 2023 were selected for study.According to the intravenous infusion dose of remifen-tanil,they were divided into low-dose group,medium-dose group and high-dose group,with 20 cases in each group.Patients in the three groups were given low-dose esketamine(0.1 μg·kg).Patients in the low-dose group were given 0.1 μg/(Kg·min)remifentanil,patients in the middle-dose group were given 0.3 μg/(Kg·min)remifentanil,and patients in the high-dose group were given 0.5 μg/(Kg·min)remifentanil.The duration of anesthesia onset,anesthesia induction,extubation,and incidence of adverse reactions were recorded in the three groups,and their hemodynamics and pain were examined for different time periods.Results:There was no significant difference in the onset time of anesthesia and the extubation time of anesthesia induction among the three groups(P＞0.05).Compared with the mean arterial pressure(MAP)and heart rate(HR),the high-dose group and the middle-dose group were lower than the low-dose group at T1 and T2,and the middle-dose group was lower than the high-dose group at T1 and T2;the levels of MAP and HR in the three groups at T2 were lower than those at T0 and T1,and those at T1 were lower than those at T(P＜0.05).Compared with the visual analogue scale(VAS)score,the T1 and T2 time periods of the high-dose group and the middle-dose group were lower than those of the low-dose group,and the T1 and T2 time periods of the middle-dose group were lower than those of the high-dose group;the levels of MAP and HR in the three groups at T2 were lower than those at T0 and T1,and those at T1 were lower than those at T0(P＜0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P＞0.05).Conclusion:Different doses of remifentanil combined with low-dose esketamine can ensure the anesthetic effect and safety of laparoscopic gynecological surgery,but the application of medi-um-dose remifentanil is more conducive to stabilizing hemodynamics and reducing the degree of pain in patients.
RemifentanilDifferent dosesLow-dose esketamineLaparoscopic gynecological surgery
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