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| Effects of combined intravenous and inhalation anesthesia used during laparoscopic myomectomy of patients on their stress status, recovery quality, and cognitive function |
| West China Guang'an Hospital, Sichuan University, Guang'an, Sichuan Province, 638000 |
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Abstract To explore the effects of combined intravenous and inhalation anesthesia used during laparoscopic myomectomy of patients on their stress status, recovery quality, and cognitive function. Methods: 114 patients who wanted laparoscopic myomectomy were selected and were divided into two groups (57 cases in each group)according to the simple random method from February 2020 to September 2021. The patients in group A were given intravenous general anesthesia, and then were given intravenous pump injection of remifentanil combined with propofol for anesthesia maintenance, while the patients in group B were given combined intravenous and inhalation anesthesia, and then were given intravenous pump injection of remifentanil combined with inhalation of sevoflurane for anesthesia maintenance. The hemodynamic indicators, such as heart rate (HR), mean arterial pressure (MAP), and blood oxygen saturation (SpO2), before anesthesia induction (T0), at 5 min before establishment of pneumoperitoneum (T1), at 5 min after pneumoperitoneum (T2), and at the end of surgery (T3), the anesthesia recovery quality, the stress status, such as cortisol (COR)level, noradrenaline (NA)level, and blood glucose (Clu)level before anesthesia induction, at the end of surgery, and at 2h after surgery, the cognitive function by Mini-Mental State Examination(MMSE)before surgery and at 6 h, 24 h, and 48 h after surgery, and the adverse drug reactions rate of the patients were compared between the two groups. Results: The values of HR and MAP of the patients in group B at T2 and T3 were significantly lower than those of the patients in group A. The spontaneous respiration recovery time, extubation time, awaking time, and orientation recovery time of the patients in group B were significantly lower than those of the patients in group A. The Steward score of the patients in group B at 15min or 30min after extubation was significantly higher than that of the patients in group A (all P＜0.05). The levels of Cor, ALD, and Glu in peripheral blood of the patients in both groups at the end of surgery and 2h after surgery were significantly higher than those before anesthesia, but which of the patients in group B were significantly lower than those of the patients in group A (P＜0.05). The MMSE scores of the patients in both groups after surgery had decreased significantly, and which of the patients in group B at postoperative 6h and 24h were significantly higher than those of the patients in group A. The incidence of cognitive impairment (3.5%)of the patients in group B at 24h after surgery was significantly lower than that (14.0%)of the patients in group A (all P＜0.05). There was no significant difference in the incidence of adverse reactions (7.0% vs. 10.5%)of the patients between the two groups (P＞0.05). Conclusion: Combined intravenous inhalation and anesthesia used during laparoscopic myomectomy of the patients can effectively maintain their hemodynamic stability, reduce their stress response and incidence rate of postoperative cognitive impairment, with higher recovery quality.
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