Study on the anesthetic effect of combined intravenous and inhalation anesthesia and total intravenous anesthesia in laparoscopic gallbladder surgery
Objective To study the anesthetic effect of combined intravenous and inhalation anesthesia and total intravenous anesthesia in laparoscopic gallbladder surgery.Methods 112 patients with laparoscopic gallbladder surgery were divided into a control group and an observation group by envelope random selection method,with 56 cases in each group.Patients in the control group underwent combined intravenous and inhalation anesthesia during surgery,while patients in the observation group underwent total intravenous anesthesia during surgery.Both groups were compared in terms of anesthesia indexes(exhalation time,recovery time,orientation recovery time),stress indexes[norepinephrine(NE),cortisol(Cor)],physiological indexes[mean arterial pressure(MAP),heart rate],immune indexes(CD3+,CD4+,CD4+/CD8+),inflammatory factors[hypersensitive C-reactive protein(hs-CRP),interleukin-8(IL-8),interleukin-6(IL-6)],and occurrence of adverse reactions.Results The extubation time,recovery time and orientation recovery time in the observation group were(6.25±0.62),(5.67±0.13)and(9.19±1.05)min,which were significantly shorter than those of(7.69±0.69),(6.95±0.22)and(14.36±1.12)min in the control group,respectively.The difference was statistically significant(P<0.05).After surgery,the levels of NE and Cor in the observation group were(7.47±0.35)and(216.88±3.30)nmol/L,respectively,which were lower than those of(9.72±0.59)and(356.13±3.25)nmol/L in the control group,and the difference was statistically significant(P<0.05).Immediately after intubation(T1),5 min after beginning of surgery(T2),and immediately after extubation(T3),the heart rate and MAP of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).After surgery,CD3+,CD4+ and CD4+/CD8+ in the observation group were(69.02±1.46)%,(43.79±0.16)%and(1.42±0.12),respectively,which were higher than those of(60.62±1.45)%,(39.68±0.18)%and(1.30±0.11)in the control group.The difference was statistically significant(P<0.05).After surgery,the levels of hs-CRP,IL-8 and IL-6 in the observation group were(12.74±3.22)mg/L,(22.25±0.22)pg/ml and(13.36±2.14)pg/ml,which were lower than those of(19.65±3.24)mg/L,(35.56±0.25)pg/ml and(24.81±2.26)pg/ml in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 1.79%,which was lower than that of 12.50%in the control group,and the difference was statistically significant(P<0.05).Conclusion Total intravenous anesthesia has a positive application value in laparoscopic gallbladder surgery,which can effectively improve the anesthetic effect,stabilize the hemodynamics of patients,reduce the stress response and inflammatory response,and reduce the impact on immune function,which is worthy of clinical promotion.
Laparoscopic gallbladder surgeryTotal intravenous anesthesiaCombined intravenous and inhalation anesthesiaAnesthetic effect
NETL
NSTL
万方数据
维普
