Efficacy and Safety of Remifentanil and Propofol-Based Total Intravenous Anesthesia in Surgery for Acute Abdomen with Infectious Shock Patients

HU Juan; CAO Huijuan; LI Jinrong; LI Xiaowei

doi:10.13919/j.issn.2095-6274.ZHJY202410002

Abstract：Objective To investigate the efficacy and safety of remifentanil combined with propofol for to-tal intravenous anesthesia in patients with acute abdominal pain and septic shock during surgery. Methods Sixty eight patients with acute abdomen accompanied by septic shock admitted to our hospital from January 2022 to De-cember 2023 were randomly divided into an observation group (remifentanil combined with propofol total intrave-nous anesthesia,34 cases) and a control group (sevoflurane combined with propofol total intravenous anesthesia,34 cases) by drawing lots. Compare the stress-related indicators,vital sign related indicators,anesthesia recovery status,and incidence of postoperative adverse reactions between two groups of patients. Results During anes-thesia induction,there was no significant difference in the levels of norepinephrine,adrenaline,and cortisol between the two groups of patients (P>0.05). During surgery and when fully awake,the levels of stress related hormones in both groups of patients were significantly increased (P<0.05). Compared with the control group,the observation group had lower levels of stress-related hormones during surgery and when fully awake (P<0.05). There was no sig-nificant difference in heart rate,systolic blood pressure,and diastolic blood pressure levels between the two groups of patients during anesthesia induction and when fully awake;During the surgery,both groups of patients showed a significant decrease in heart rate,systolic blood pressure,and diastolic blood pressure (P<0.001);Compared with the control group,the observation group had higher average heart rate,systolic blood pressure,and diastolic blood pressure during surgery (P<0.001). Compared with the control group patients,the observation group patients had a shorter time required to recover sponta-neous breathing,open their eyes upon exhalation,and extubate after anesthesia (P<0.001);The observation group had a lower dose of propofol during surgery (P<0.05). The incidence of postoperative adverse reactions in the observation group was lower than that in the control group (P<0.05). Conclusion For patients with acute abdomen accompanied by septic shock,using remifentanil com-bined with propofol for total intravenous anesthesia is beneficial in reducing the body's stress response,maintaining stable vital signs,achieving rapid recovery after anesthesia,and high safety.