异丙酚联合瑞芬太尼和 LMA 在腹腔镜卵巢囊肿切除术中的应用

Jakaria Kabir, Md. Abdul Alim, Beauty Choudhury, Md. Liaquat Ali, Jannatul Ferdoush Jublee, Rasha Nazia Zishan, Makshoda Begum
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摘要

导言:在腹腔镜卵巢囊肿切除术中应用异丙酚联合瑞芬太尼和喉罩气道(LMA)是微创妇科手术麻醉技术领域的一大进步。研究目的本研究旨在评估异丙酚联合瑞芬太尼和 LMA 在腹腔镜卵巢囊肿切除术中的应用。研究方法这项横断面研究于 2015 年 1 月至 2018 年 12 月在孟加拉国北孟加拉医学院和博古拉医学院进行,纳入了 120 名接受腹腔镜卵巢囊肿切除术的女性患者。她们被分为两组,每组 60 人:A 组接受瑞芬太尼联合异丙酚麻醉,B 组接受芬太尼联合异丙酚麻醉,所有病例均使用 LMA。结果研究组之间的人口统计学特征差异无统计学意义(P>0.05)。ASA I-III 级分布相当(P 值为 0.6035 至 0.8529)。与 B 组相比,A 组手术时间更短,失血量更少。与 B 组相比,A 组的住院时间更短。值得注意的是,A 组的麻醉诱导和恢复时间明显更短(P≤0.05),OAAS 评分更高,表明恢复更快。A 组在术后不同时间段的疼痛 VAS 评分也明显较低(P≤0.05),表明疼痛控制较好。除咽喉痛两组相同外,恶心、瘙痒、呕吐和腹痛等并发症在 B 组略高。结论使用异丙酚联合瑞芬太尼和喉罩气道进行腹腔镜卵巢囊肿切除术的麻醉管理效果更好,恢复更快,疼痛控制更有效,并发症更少。
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The Application of Propofol Combined with Remifentanil and LMA in Laparoscopic Ovarian Cystectomy
Introduction: The application of Propofol combined with Remifentanil and Laryngeal Mask Airway (LMA) in laparoscopic ovarian cystectomy represents a significant advancement in the field of anesthetic techniques for minimally invasive gynecological surgeries. Aim of the study: The aim of this study was to evaluate the application of propofol combined with remifentanil and LMA in laparoscopic ovarian cystectomy. Methods: This cross-sectional study at North Bengal Medical Colleges and Bogura Medical College, Bangladesh from January 2015 - December 2018, included 120 female patients undergoing laparoscopic ovarian cystectomy. They were split into two groups of 60: Group A received remifentanil with propofol, and Group B received fentanyl with propofol for anesthesia, with LMA used in all cases. Result: There were no statistically significant difference (p>0.05) between the study groups in demographic characteristics. ASA grades I-III distributed comparably (p-values 0.6035 to 0.8529). Group-A had a shorter surgical time and less blood loss compared to Group-B. Hospital stay was shorter for Group-A than Group-B. Notably, Group-A showed significantly (p≤0.05) better anesthesia induction and recovery times, and higher OAAS scores, indicating quicker recovery. Group-A also reported significantly (p≤0.05) lower VAS scores for pain at various post-operation intervals, suggesting better pain management. Complications like nausea, pruritus, vomiting, and abdominal pain were slightly higher in Group-B, except for sore throat, which was equal in both groups. Conclusion: The use of propofol combined with remifentanil and Laryngeal Mask Airway for laparoscopic ovarian cystectomy has better anesthetic management, quicker recovery, more effective pain control, and fewer complications.
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