ABSTRACT
Objective To investigate the influence of two general anesthestic modes on postoperative cognitive dysfunction (POCD) in the patients undergoing laparoscopic radical hysterectomy .Methods One hundred ASA Ⅰ‐Ⅱ patients undergoing lapa‐roscopic radical hysterectomy were randomly allocated to the propofol group (group P) and sevoflurane group (group S) ,50 cases in each group .The anaesthesia time ,total dose of sufentanil ,total dose of vecuronium ,recovery time ,recovery time for regaining ori‐entation and complications during anesthetic recovery period were recorded .The cognitive function was assessed by the mini‐mental state examination (MMSE) on preoperative 1 d (T0 ) ,postoperative 1 d (T1 ) ,postoperative 3 d ,(T2 ) ,postoperative 7 d (T3 ) ,post‐operative 1 month (T4 )、postoperative 3 months (T5 ) and the POCD occurrence situation was evaluated by adopting the Z scoring . Results The total dose of sufentanil and vecuronium in the group S was lower than that in the group P (P<0 .05) ,the recovery time and time for regaining orientation in the group S was longer than that in the group P (P<0 .05);the incidence rates of shive‐ring ,dysphoria and upper respiratory tract obstruction in the group S were higher than those in the group P (P<0 .05) .There were no statistically significant difference in the MMSE scores between the two groups (F=0 .14 ,P=0 .709);the MMSE scores in each group had statistical differences among different time points (F=74 .46 ,P<0 .01) .The interaction effect existed between the gen‐eral anesthetic mode and time with MMSE score (F=7 .99 ,P<0 .01);the MMSE scores at T1 ,T2 in the group S were lower than those in the group P (P<0 .05) .The incidence rate of POCD at T1 ,T2 、T3 ,T4 in the group S was higher than that in the group P (P<0 .05) .Conclusion The incidence rate of POCD in the patients undergoing laparoscopic radical hysterectomy by adopting sevoflurane inhalation general anaesthesia is higher than that by adopting propofol anesthesia ,but which has no difference after postoperative 3 months .
ABSTRACT
Objective To explore the effect of laryngeal mask airway used in gynaecological laparoscopy and the nursing experience. Methods 80 selected patients undergoing gynaecological laparoscopy were divided into two equal-sized groups for airway management with the laryngeal mask airway group(L group)and the control group(C group). MAP、HR、SPO2、PETCO2 of all patients were observed at before induction, at airway insertion, at pneumoperitoneum, at airway removal. The ratio of postoperative nausea、vomiting、laryngismus、pharyngalgia、cerchnus、back streaming and aspiration were recorded. Results MAP and HR increased significantly in C group than L group at airway insertion and removal. SPO2 and PETCO2 had no significant difference in two groups at any time. The ratio of postoperative nausea、pharyngalgia、cerchnus was respectively higher in C group than L group. The ratio of laryngismus、vomitiong、backstreaming and aspiration in L group was similar with C group. Conclusions Laryngeal mask airway is an effective airway device for gynaecological laparoscopy, it has low incidence of complication, and make nursing care easy during operation.