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| Anesthetic effect of ropivacaine combined with sevoflurane inhalation anesthesia used during laparoscopic hysteromyomectomy of patients with uterine fibroids and its influence on their prognosis |
| Shanghai Public Health Clinical Center, Shanghai, 201508 |
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Abstract To investigate the anesthesia effect of ropivacaine combined with sevoflurane inhalation anesthetic used during laparoscopic hysteromyomectomy(LM) of patients with uterine fibroids(UF), and to study its influence on the prognosis of the patients. Methods: A total of 128 patients with UF who wanted LM were selected and were randomly divided into study group(64 patients with ropivacaine combined with sevoflurane inhalation for anesthesia) and control group(64 patients with sevoflurane inhalation for anesthesia) by double-blind method from April 2022 to February 2024. The anesthetic effect, the perioperative hemodynamics, the pain degree evaluated by visual analogue scale(VAS), the inflammatory factors levels change and the recovery of postoperative cognitive function evaluated by MMSE and MoCA scores of the patients were compared between the two groups. Results: The time of spontaneous breathing recovery(6.12±0.86 min), the time of wake-up(3.56±0.78 min), the verbal response time(7.62±0.53 min) and the extubation time(14.65±2.26 min) of the patients in the study group after operation were significantly shorter than those(7.34±1.36 min, 4.89±0.93 min and 10.58±1.17 min and 17.56±2.78 min) of the patients in the control group. The heart rate(71.43±6.07 beats/min) and the mean arterial pressure(88.93±6.54 mmHg) of the patients in the study group after operation were significantly higher than those(69.34±5.32 beats/min and 86.51±6.91 mmHg) of the patients in the control group. The visual analogue score(2.41±0.49 points), and the levels of serum tumor necrosis factor-α(18.96±3.07 ng/L) and interleukin-6(18.54±3.08 pg/ml) of the patients in the study group at 12 hours after operation were significantly lower than those(3.65±0.68 points, 26.94±4.53 ng/L and 24.83±4.15 pg/ml) of the patients in the control group. The scores of MMSE(27.39±1.58 points) and MoCA(28.42±0.97 points) of the patients in the study group in 1 day after operation were significantly higher than those(25.86±1.64 points and 26.48±1.03 points) of the patients in the control group(all P<0.05). Conclusion: Ropivacaine combined with sevoflurane inhalation anesthesia used during LM of the patients with UF has the good anesthetic effect, can stabilize the hemodynamics, reduce the pain degree, inhibit the inflammatory stress response and promote the recovery of cognitive function of the patients, and which has important reference significance for the clinical anesthesia application.
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