摘要
目的研究探讨脑电双频指数(bispectral index,BIS)监测下阿芬太尼复合瑞马唑仑在胃镜食管静脉曲张术中的镇痛效果及对应激反应的影响。方法便利选取2023年8月—2024年4月新昌县人民医院收治的60例胃镜食管静脉曲张患者为研究对象,按不同麻醉方法分组分为观察组、对照组,每组30例。两组患者均BIS监测下进行手术治疗,观察组以阿芬太尼复合瑞马唑仑静脉麻醉,对照组以舒芬太尼复合瑞马唑仑静脉麻醉。比较两组血流动力学指标、麻醉苏醒时间、镇痛效果、应激反应指标及不良反应发生情况。结果观察组患者在麻醉诱导时、插管即刻、手术进行时及手术结束时的心率、脑电双频指数低于对照组,血氧饱和度高于对照组,差异均有统计学意义(P均<0.05)。观察组麻醉苏醒时间短于对照组,应激反应指标水平低于对照组,差异均有统计学意义(P均<0.05)。观察组术后1、3、6、12 h的视觉模拟评分分别为(1.71±0.46)分、(2.58±0.49)分、(3.16±0.77)分、(3.45±0.73)分,均低于对照组的(2.55±0.53)分、(3.10±0.56)分、(3.89±0.83)分、(4.23±0.51)分,差异均有统计学意义(t=3.045,4.149,3.483,4.434;P均<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论BIS监测下阿芬太尼复合瑞马唑仑在胃镜食管静脉曲张术中的镇痛效果良好,可改善血流动力学,提升麻醉苏醒质量,降低术后应激反应,安全性良好。
Objective To investigate the analgesic effect of alfentanil combined with remimazolam in endoscopic esophageal varices and its effect on stress response under the monitoring of bispectral index(BIS).Methods A total of sixty patients with endoscopic esophageal varices admitted to Xinchang County People′s Hospital from August 2023 to April 2024 were conveniently selected as the research objects and divided into observation group and control group ac-cording to different anesthesia methods,with thirty cases in each group.The patients in the two groups were treated with operation under BIS monitoring.The observation group was given intravenous anesthesia with alfentanil combined with remimazolam,and the control group was given intravenous anesthesia with sufentanil combined with remima-zolam.The hemodynamic indexes,anesthesia recovery time,analgesic effect,stress response indexes and adverse reac-tions were compared between the two groups.Results The heart rate and bispectral index of the observation group were lower than those of the control group at the time of anesthesia induction,intubation,operation and the end of op-eration,and the blood oxygen saturation was higher than that of the control group,the differences were statistically sig-nificant(all P<0.05).The anesthesia recovery time of the observation group was shorter than that of the control group,stress response indexes were lower than those of the control group,and the differences were statistically significant(all P<0.05).The visual analogue scores of the observation group at 1,3,6 and 12 h after operation were 1.71±0.46,2.58±0.49,3.16±0.77 and 3.45±0.73,which were lower than 2.55±0.53,3.10±0.56,3.89±0.83,4.23±0.51 of the control group,and the differences were statistically significant(t=3.045,4.149,3.483,4.434;all P<0.05).There was no sig-nificant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The analgesic effect of alfentanil combined with remimazolam under BIS monitoring in endoscopic esophageal variceal surgery is good,which can improve hemodynamics,improve the quality of anesthesia recovery,reduce postoperative stress re-sponse,and has good safety.
作者
李文明
俞丽君
陈巍巍
LI Wenming;YU Lijun;CHEN Weiwei(Department of Anesthesiology,Xinchang County People′s Hospital,Shaoxing 312500,Zhejiang,China)
出处
《系统医学》
2025年第12期6-9,26,共5页
Systems Medicine
基金
新昌县科技计划项目(JFZC2306)。
关键词
胃镜食管静脉曲张术
脑电双频指数
阿芬太尼
瑞马唑仑
镇痛效果
应激反应
Gastroscopy for esophageal varices surgery
bispectral index
Alfentanil
Remimazolam
Analgesic effect
Stress response
