七氟醚联合瑞芬太尼麻醉对腹腔镜下子宫肌瘤切除术患者应激反应及血流动力学的影响

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Abstract Objective To study the effects of Sevoflurane combined with Remifentanil anesthesia on stress response and hemodynamics in patients undergoing laparoscopic hysteromyomectomy. Methods Eighty-six female patients who were scheduled to undergo laparoscopic hysteromyomectomy in 908th Hospital of the Joint Logistics Support Force of the Chinese People′s Liberation Army from October 2016 to October 2018 were selected as the study subjects. They were divided into the study group and the control group according to the random number table method, 43 cases in each group. The control group was anesthetized by Remifentanil combined with Propofol, while the study group was anesthetized with Remifentanil combined with Sevoflurane. The levels of cortisol (COR), adrenaline (A), norepinephrine (NA), C-reactive protein (CRP), and blood glucose (GLU) at 5 min before anesthesia (T0), 30 min after pneumoperitoneum (T1), the end of operation (T2), postoperative 2 h (T3), and hemodynamic parameters such as heart rate (HR), mean arterial pressure (MAP), systolic blood pressure (SBP) and oxygen saturation (SpO2) at T0, T1 and T2, and the incidence of postoperative adverse reaction was compared between the two groups. Results The levels of COR, A, NA and GLU at T0-T3 in the two groups were increased at first and then decreased, while those at T1 and T2 of the study group were lower than those of the control group (P < 0.05); the CRP level of the two groups showed an increasing trend at each time period, and the study group was lower than that of the control group in the same period (P < 0.05). HR, MAP and SBP at T0 - T2 was increased at first and then decreased, while those at T1 and T2 of the study group were lower than those of the control group (P < 0.05). There was no significant difference in SpO2 level between the two groups at all stages (P > 0.05). The incidence of postoperative adverse reactions in the study group (13.95%) was lower than that in the control group (32.56%) (P < 0.05). Conclusion Sevoflurane combined with Remifentanil anesthesia in laparoscopic hysteromyomectomy can effectively reduce the stress reaction and hemodynamic fluctuation of patients during operation, and reduce the occurrence of adverse reactions after operation.

Key words： Uterine leiomyoma Inhalation of anesthetics Psychomotor stimulation Hemodynamics

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	AI Jinlian XIAO Jinhui LIU Rong WANG Minhua GUI Xinxing

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AI Jinlian XIAO Jinhui LIU Rong WANG Minhua GUI Xinxing. Effect of Sevoflurane combined with Remifentanil anesthesia on stress response and hemodynamics in patients undergoing laparoscopic hysteromyomectomy[J]. 中国医药导报, 2019, 16(31): 103-106.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I31/103

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