摘要
目的 评价七氟烷+瑞芬太尼与异丙酚+瑞芬太尼在脊椎骨折麻醉中的运用效果。方法 70例脊椎骨折患者,随机分为参照组及实验组,每组35例。参照组运用七氟烷+瑞芬太尼麻醉,实验组运用异丙酚+瑞芬太尼麻醉。对比两组疼痛情况,麻醉前后的生命体征指标,麻醉后的血清炎症因子水平,手术出血量与麻醉后恢复指标,不良反应发生情况。结果 实验组的疼痛情况轻于参照组,差异具有统计学意义(Z=2.937, P<0.05)。麻醉后,两组患者的心率、呼吸频率低于本组麻醉前,但实验组患者的心率(75.3±9.1)次/min、呼吸频率(14.3±2.3)次/min高于参照组的(70.3±8.2)、(12.3±1.5)次/min,差异具有统计学意义(P<0.05)。两组患者麻醉前后的血氧饱和度组间组内对比,差异无统计学意义(P>0.05)。两组麻醉后的白细胞介素-6、细胞间粘附因子-1、血管细胞粘附因子-1、内皮细胞选择素、血小板选择蛋白水平对比,差异无统计学意义(P>0.05)。两组手术出血量对比,差异无统计学意义(P>0.05);实验组麻醉后呼吸恢复时间(4.06±1.57)min、苏醒时间(7.64±2.34)min、拔管时间(13.06±4.23)min、定向力恢复时间(12.24±1.26)min短于参照组的(8.51±2.64)、(12.64±2.54)、(18.52±7.34)、(20.24±2.57)min,差异具有统计学意义(P<0.05)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论 在脊椎骨折手术中,利用异丙酚+瑞芬太尼的麻醉效果更加理想,且对生命体征的影响小,有较高的临床应用价值。
Objective To evaluate the effect of sevoflurane or propofol combined with remifentanil on the anesthesia of patients undergoing spinal fracture surgery.Methods A total of 70 patients with spinal fracture were randomly divided into the reference group and the experimental group,with 35 cases in each group.The reference group was anesthetized with sevoflurane and remifentanil,while the experimental group was anesthetized with propofol and remifentanil.Both groups were compared in terms of pain status,vital sign indicators before and after anesthesia,serum inflammatory factor levels after anesthesia,intraoperative blood loss and recovery after anesthesia,and adverse reactions.Results The pain status in the experimental group was less severe than that in the reference group,and the difference was statistically significant(Z=2.937,P<0.05).After anesthesia,the heart rate and respiratory rate in both groups were lower than those before anesthesia in this group;however,the heart rate of(75.3±9.1)beats/min and respiratory rate of(14.3±2.3)times/min in the experimental group were higher than those of(70.3±8.2)beats/min and(12.3±1.5)times/min in the reference group;the differences were statistically significant(P<0.05).There was no statistically significant difference between and within the two groups in blood oxygen saturation before and after anesthesia(P>0.05).After anesthesia,there was no statistically significant difference in the levels of interleukin-6,intercellular adhesion molecule-1,vascular cell adhesion molecule-1,endothelial cell selectin and platelet selective protein between the two groups(P>0.05).There was no statistically significant difference in intraoperative blood loss between the two groups(P>0.05).After anesthesia,in the experimental group,the respiratory recovery time was(4.06±1.57)min,the recovery time was(7.64±2.34)min,the extubation time was(13.06±4.23)min,and the orientation recovery time was(12.24±1.26)min,which were shorter than those of(8.51±2.64),(12.64±2.54),(18.52±7.34),and(20.24±2.57)min in the reference group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion In spinal fracture surgery,the anesthetic effect of propofol with fentanyl is more ideal,and has little impact on vital signs,which contains high clinical application value.
作者
卜令标
BU Ling-biao(Anesthesia Department,Zoucheng People's Hospital,Zoucheng 273500,China)
出处
《中国现代药物应用》
2023年第19期32-36,共5页
Chinese Journal of Modern Drug Application
关键词
七氟烷
异丙酚
瑞芬太尼
脊椎骨折
麻醉效果
Sevoflurane
Propofol
Remifentanil
Spinal fracture
Anesthetic effect
