Comparison of the Effects and Safety of Different Induction Doses of Propofol Combined with Remifentanil in Obese Patients with Cholecystolithiasis Undergoing Laparoscopic Surgery
Objective To compare the effects and safety of different induction doses of propofol combined with remifentanil in obese patients with cholecystolithiasis undergoing laparoscopic surgery.Methods A total of 172 obese patients with body mass index(BMI)≥28 kg/m2 who underwent laparoscopic surgery for cholecystolithiasis in The Third People's Hospital of Zhengzhou from June 2020 to June 2023 were enrolled and randomly divided into group A,B,C,and D by a computer-generated random number table,with 43 cases in each group.They were induced with propofol 0.3,0.4,0.5,and 0.6 mg/kg combined with remifentanil 0.5-1 μg/kg,respectively.The anesthetic drug consumption,anesthetic induction time,surgical situation,anesthetic recovery time,anesthetic effect,hemodynamic parameters at T0(before entry),T1(at the beginning of anesthesia induction),T2(at the end of endotracheal intubation),T3(at the end of surgery)and adverse reactions were compared among the four groups.Results There were no significant differences in the consumption of remifentanil,sufentanil,rocuronium and propofol among the four groups(P>0.05).Compared with group A,the anesthetic induction time was shortened in group B,C and D(P<0.05).Compared with group A and B,the anesthetic recovery time and spontaneous breathing recovery time,extubation time were prolonged in group C and D(P<0.05),and compared with group C,the anesthetic recovery time and spontaneous breathing recovery time,extubation time were prolonged in group D(P<0.05).Among the groups:compared with group A and B,mean arterial pressure(MAP)and heart rate(HR)were decreased in group C and D at T1,and increased at T2 and T3(P<0.05);compared with group C,MAP and HR were decreased in group D at T1,and increased at T2 and T3(P<0.05).In the same group:compared with T0,MAP and HR were decreased in all four groups at T1(P<0.05),and increased at T2(P<0.05),MAP and HR were increased in group C and D at T3(P<0.05);compared with T1,MAP and HR were increased in all four groups at T2 and T3(P<0.05);compared with T2,MAP and HR were decreased in all four groups at T3(P<0.05).Compared with group A,the grade I component ratios of anesthesia effect in groups B,C and D were increased,and the grade II component ratios were decreased(P<0.05).Compared with group A,B and C,the incidence of airway obstruction,bradycardia was increased in group D(P<0.05).Conclusion Propofol 0.4,0.5,0.6 mg/kg combined with remifentanil have better sedative effect than propofol 0.3 mg/kg in obese patients with cholecystolithiasis undergoing laparoscopic surgery,propofol 0.3,0.4 mg/kg have shorter anesthetic recovery time than propofol 0.5,0.6 mg/kg,the hemodynamics are more stable,the adverse reactions are less,and comprehensively considering propofol 0.4 mg/kgcombined with remifentanil have better sedative effect and safety.
ObesityLaparoscopic surgery for cholecystolithiasisPropofolRemifentanilSafety
NETL
NSTL
万方数据
