Application of Different Doses of Remifentanil Combined with Sevoflurane in Ambulatory Laparoscopic Cholecystectomy under Pain Threshold Index Monitoring
10.12259/j.issn.2095-610X.S20250619
- VernacularTitle:镇痛指数监测下不同剂量瑞芬太尼复合七氟烷在日间腹腔镜胆囊切除术中的应用
- Author:
Jiaqi LIU
1
;
Siqi GAO
;
Ningli ZHANG
;
Jie OUYANG
;
Jun JIANG
;
Yuan LI
;
Fuquan LI
;
Chen ZHOU
Author Information
1. 昆明医科大学第二附属医院甲状腺乳腺外科,云南 昆明 650101
- Keywords:
Sevoflurane;
Remifentanil;
General anesthesia;
Pain threshold index;
Laparoscopy;
Cholecystectomy
- From:
Journal of Kunming Medical University
2025;46(6):149-155
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the application value of different doses of remifentanil combined with sevoflurane under pain threshold index(PTi)monitoring in ambulatory laparoscopic cholecystectomy.Methods 152 patients undergoing laparoscopic cholecystectomy under general anesthesia were selected from December 2023 to June 2024 at the Second Affiliated Hospital of Kunming Medical University.Patients were randomly divided into R1 group(n=38),R2 group(n=38),R3 group(n=38),and R4 group(n=38)using a random number table.On the basis of sevoflurane at 0.7 minimum alveolar concentration(MAC),patients in R1～R4 groups were combined with 0.1,0.2,0.3,and 0.4 μg/kg·min remifentanil,respectively.The changes in PTi at different time points,pre-and post-operative blood stress indicators[cortisol(Cor),norepinephrine(NE),and blood glucose(Glu)concentrations]were compared,and the incidence of intraoperative hypertension,hypotension,tachycardia,bradycardia,and postoperative nausea and vomiting were recorded.Results Compared with R1 group,PTi in R2,R3,and R4 groups decreased from the start of surgery(T3)to 5 min after extubation(T11)(P<0.05);compared with R2 group,PTi in R3 and R4 groups was lower at T3～T11(P<0.05);no statistically significant difference was found in PTi changes between R3 and R4 groups at different time points(P>0.05).Postoperative Cor,NE,and Glu concentrations showed statistically significant differences among the four groups(P<0.001),but no significant difference was found preoperatively(P>0.05).Compared with preoperative values,Cor,NE,and Glu levels significantly increased in all groups(P<0.001),with R1 group>R2 group>R4 group>R3 group.The incidence of intraoperative hypertension,hypotension,bradycardia,and tachycardia showed statistically significant differences(P<0.001),with R4>R1>R2=R3.The incidence of postoperative nausea and vomiting also showed statistically significant differences(P<0.001),with R1 group>R4 group>R2 group>R3 group.Conclusion Sevoflurane at 0.7 MAC combined with 0.3 μg/kg·min remifentanil provides good analgesic effects for patients undergoing ambulatory laparoscopic cholecystectomy,reduces stress response,and has high safety,making it worthy of clinical promotion.
