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| Effect of different concentration of sevoflurane combined with remifentanil intravenous anesthesia used in laparoscopic hysterectomy of patients and its influence on the pain score and stress response |
| 1. Jiaxing Xiuzhou District Maternity and Child Health Care Hospital, Jiaxing, Zhejiang Province, 314031; 2. Jiaxing Maternity and Child Health Care Hospital, Zhejiang Province |
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Abstract To investigate the efficacy and safety of the effect of different concentration of sevoflurane combined with remifentanil intravenous anesthesia used in laparoscopic hysterectomy(LH) of patients. Methods: 96 patients who wanted LH were randomly selected and were divided into 32 patients with lowconcentration sevoflurane of 0.5% combined with remifentanil for anesthesia in group A, 32 patients with high-concentration sevoflurane of 1.5% combined with remifentanil for anesthesia in group B, and 32 patients with propofol combined with remifentanil for anesthesia in group C according to the numerical table method from January 2018 to January 2023. The levels of cortisol(COR) and blood glucose(GLU), and the values of heart rate(HR), mean arterial pressure(MAP) and blood oxygen saturation(SpO2), the pain score by visual analogue scale(VAS) and the rate of adverse reaction of the patients were compared among three groups. Results: The awakening time, the spontaneous breathing recovery time, the speech response time, the orientation recovery time and the dosage of remifentanil of the patients in the three groups had decreased significantly, and the dosage of remifentanil used of the patients in group A and in group B was significantly lower than that of the patients in group C. The VAS score of the patients in the three groups at 10min and 30min after operation had decreased significantly, and which of the patients in group A(6.02±0.40 points and 3.07±0.11 points) and in group B(5.89±0.34 points and 3.05±0.09 points) were significantly lower than those(7.82±0.38 points and 4.68±0.29 points) of the patients in group C. The HR value of the patients in the three groups had decreased significantly, and the MAP value of the patients in the three groups had increased significantly, and the changes rangeability of which of the patients in group A and group B were significantly more than those of the patients in group C. The levels of GLU and COR of the patients in the three groups after operation had decreased significantly, and which of the patients in group A(4.57±0.18 mmol/L and 346.07±4.81 nmol/L) and in group B(4.61±0.17 mmol/L and 339.11±4.32 nmol/L) were significantly lower than those(5.29±0.20 mmol/L and 365.22±5.59 nmol/L) of the patients in group C(all P<0.05). There was no significant difference in the incidence of adverse reactions(4.2% vs. 4.2% vs. 6.3%) of the patients among the three groups(P=0.655). Conclusion: The application of different concentrations of sevoflurane combined with remifentanil intravenous anesthesia used in LH of the patients can improve their quality of anesthesia, reduce their surgical pain and stress response, and improve their hemodynamics, and without increasing their risk of adverse reactions. The high-concentration sevoflurane regimen used during laparoscopic hysterectomy can reduce the dosage of propofol used during operation.
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