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Analgesic effect of remifentanil combined with propofol used in laparoscopic hysterectomy and its influence on the hemodynamics and stress indexes |
1. Pan'an County People's Hospital, Pan'an, Zhejiang Province, 322399; 2. Jinhua Municipal Centeral Hospital, Jinhua, Zhejiang Province |
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Abstract To investigate the analgesic effect of remifentanil combined with propofol used in laparoscopic hysterectomy of patients, and to study its influence on the hemodynamics and stress indexes of the patients. Methods: 128 patients who wanted laparoscopic hysterectomy were selected and were randomly divided into observation group and control group (64 cases in each group) from January 2021 to December 2023. Laparoscopic hysterectomy was performed in both groups. The patients in the control group were given sufentanil combined with propofol for anesthesia induction, and then pumped continuously for analgesic maintenance during laparoscopic hysterectomy. The patients in the observation group were given remifentanil combined with propofol for anesthesia induction, and then pumped continuously for analgesic maintenance during laparoscopic hysterectomy. The values of hemodynamic indexes, stress indexes and pain indexes, the visual analogue score (VAS) and the adverse reactions rate of the patients were compared between the two groups. Results: The values of heart rate and mean arterial pressure of the patients in the observation group after anesthesia induction, at tracheal intubation, at the beginning of the operation and immediately after the operation were significantly lower than those of the patients in the control group. The levels of epinephrine, cortisol, serotonin and neuropeptide of the patients in the two groups immediately after operation were significantly lower than those before operation, and which (60.26±5.41 pg/ml, 84.22±5.03 ng/ml, 90.24±9.31 ng/L and 121.69±13.47μg/L) of the patients in the observation group were lower significantly than those (69.96±5.15 pg/ml, 92.15±6.39 ng/ml, 139.64±12.13 ng/L and 160.55±16.36μg/L) of the patients in the control group. The pain score of the patients in the two groups immediately after operation were significantly lower than that before operation, and which (2.95±0.21 points) of the patients in the observation group was significantly lower than that (3.37±0.32 points) of the patients in the control group (all P<0.05). There was no significant difference in the incidence of adverse reactions (9.4% vs. 3.1%) of the patients between the two groups (P>0.05). Conclusion: Remifentanil combined with propofol used in aparoscopic hysterectomy for anesthesia can significantly improve the hemodynamic indexes and stress level, can reduce the pain mediator level and VAS score of the patients, and without increasing the adverse reactions.
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