盐酸奥布卡因凝胶联合丙帕他莫对腹腔镜胆囊胆总管手术患者心血管应激反应、麻醉效果及血流动力学的影响
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R614

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安徽省重点研究与开发计划项目(2022e07020024);


Effect of oxybuprocaine hydrochloride gel combined with propacetamol on cardiovascular stress,anaesthesia effect and haemodynamics in pa-tients undergoing laparoscopic cholecystobiliary surgery
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    摘要:

    目的:探讨盐酸奥布卡因凝胶联合丙帕他莫对腹腔镜胆囊胆总管手术患者心血管应激反应、麻醉效果及血流动力学的影响。方法:选取行腹腔镜胆囊胆总管手术的80例患者作为研究对象,根据术中采用的不同麻醉方案分为对照组及联合组,每组各40例。对照组予以丙帕他莫静脉注射;联合组在对照组基础上予以盐酸奥布卡因凝胶表面麻醉。记录并比较两组患者手术时间、麻醉时间、苏醒时间、拔管时间、血氧饱和度(SaO2)、心率(HR)、平均动脉压(MAP)、儿茶酚胺、皮质醇、血糖、疼痛[视觉模拟评分表(VAS)]及不良反应发生情况。结果:两组患者手术时间、麻醉时间、苏醒时间及拔管时间均无统计学差异(P>0.05)。拔管后15 min及30 min,联合组HR及MAP均低于对照组(P<0.05)。术后1 d,两组患者儿茶酚胺、皮质醇及血糖均升高,但联合组低于对照组(P<0.05)。拔管即刻、拔管后15 min及拔管后30 min,联合组VAS评分均低于对照组(P<0.05)。联合组不良反应发生率低于对照组(P<0.05)。结论:在腹腔镜胆囊胆总管手术中,相较于单用丙帕他莫麻醉,联合盐酸奥布卡因凝胶麻醉较有利于降低患者术后疼痛及血流动力学波动程度,且可有效抑制患者术后心血管应激反应,有助于提高患者导尿管耐受度。

    Abstract:

    Objective:To investigate the effects of oxybuprocaine hydrochloride gel combined with propacetamol on cardio-vascular stress,anaesthesia and haemodynamics in patients undergoing laparoscopic cholecystocholedochotomy.Methods:80 pa-tients undergoing elective laparoscopic cholecystocholangiography were selected as study subjects and divided into a control group and a combined group based on different anesthesia protocols used during the operation,with 40 cases in each group.The control group received propacetamol intravenous injection,and the combined group received topical anesthesia with oxybupro-caine hydrochloride gel in addition to the treatment given to the control group.The operation time,anesthesia time,recovery time,extubation time,blood oxygen saturation(SaO2),heart rate(HR),mean arterial pressure(MAP),catecholamines,corti-sol,blood glucose,pain[Visual Analog Scale(VAS)],and the incidence of adverse reactions were recorded and compared be-tween the two groups.Results:There were no significant differences in operation time,anesthesia time,emergence time,and ex-tubation time between the two groups of patients(P>0.05).At 15 and 30 min post-extubation,both HR and MAP were lower in the combination group compared to the control group(P<0.05).On postoperative day 1,catecholamines,cortisol,and blood glucose levels were elevated in both groups,but the levels were lower in the combination group compared to the control group(P<0.05).VAS scores were lower in the combination group compared to the control group immediately after extubation,and at 15 min and 30 min post-extubation(P<0.05).The incidence of adverse reactions was lower in the combination group com-pared to the control group(P<0.05).Conclusion:In laparoscopic cholecystobiliary choledochotomy,compared with propaceta-mol anaesthesia alone,combined with oxybuprocaine hydrochloride gel anaesthesia is more conducive to reducing the degree of postoperative pain and haemodynamic fluctuations of the patient,and can effectively inhibit the patient's level of postoperative cardiovascular stress response,which can help to increase the degree of patient's tolerance to catheterisation.

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胡文举;叶苗苗;柏耀林;.盐酸奥布卡因凝胶联合丙帕他莫对腹腔镜胆囊胆总管手术患者心血管应激反应、麻醉效果及血流动力学的影响[J].川北医学院学报,2025,40(11):1398-1402.

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  • 在线发布日期: 2025-12-22
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