Effect of target controlled infusion of sufentanil and remifentanil combined anesthesia for patients undergoing laparoscopic radical resection of colorectal cancer
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摘要: 目的 观察靶控输注舒芬太尼和瑞芬太尼复合麻醉在腹腔镜结直肠癌根治术中的应用效果。 方法 选择拟行腹腔镜结直肠癌根治术的72例患者作为研究对象,采用随机数字表法分为试验组38例和对照组34例。对照组采用靶控瑞芬太尼复合麻醉,试验组采用靶控舒芬太尼和瑞芬太尼复合麻醉。比较2组应激反应、血流动力学、恢复效果和不良反应等情况。 结果 气腹后30 min(T1时点)、拔管后5 min(T2时点)、拔管后120 min(T3时点),试验组血清肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)水平均低于对照组,差异有统计学意义(P<0.01); T1、T2、T3时点,试验组收缩压(SBP)、舒张压(DBP)、心率(HR)均低于对照组,差异有统计学意义(P<0.05或P<0.01); 试验组苏醒时间(9.12±1.24)min、拔管时间(13.45±2.05)min, 分别短于对照组的(16.54±2.31)、(23.12±3.24)min, 差异有统计学意义(P<0.01); 试验组不良反应发生率为13.16%, 低于对照组的35.29%, 差异有统计学意义(P<0.05)。 结论 靶控输注舒芬太尼和瑞芬太尼复合麻醉有助于缓解腹腔镜结直肠癌根治术患者的应激反应,可维持血流动力学相对稳定,降低不良反应发生率。Abstract: Objective To observe effect of target controlled infusion of sufentanil and remifentanil combined anesthesia for patients undergoing laparoscopic radical resection of colorectal cancer. Methods A total of 72 patients who prepared to undergo laparoscopic radical resection of colorectal cancer were divided into the experimental group(n=38)and the control group(n=34). The control group was given target controlled infusion of remifentanil and other anesthetic drugs, while the experimental group was given target controlled infusion of sufentanil and remifentanil combined anesthesia. Stress response, hemodynamics, recovery effect and adverse reactions were compared between two groups. Results The experimental group had significantly lower levels of serum adrenaline(E), norepinephrine(NE), cortisol(Cor)than the control group at 30 min after pneumoperitoneum established(T1), 5 min after extubation(T2), and 120 min after extubation(T3)(P<0.01). Systolic blood pressure(SBP), diastolic blood pressure(DBP)and heart rate(HR)at time points of T1, T2 and T3 in the experimental group were significantly lower than those in the control group(P<0.05 or P<0.01). Awakening time and extubation time were(9.12±1.24)min and(13.45±2.05)min, which were shorter than(16.54±2.31)min and(23.12±3.24)min in the control group(P<0.01); the incidence of adverse reactions in the experimental group was 13.16%, which was significantly lower than 35.29% in the control group(P<0.05). Conclusion Target controlled infusion - of sufentanil and remifentanil combined anesthesia can help to relieve the stress response of patients undergoing laparoscopic radical resection of colorectal cancer, maintain the relative stability of hemodynamics, and reduce incidence of adverse reactions.
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Keywords:
- colorectal cancer /
- target controlled infusion /
- sufentanil /
- remifentanil /
- stress response /
- hemodynamics
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