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| Effects of Remifentanil Combined with Propofol or Sevoflurane in Gastrectomy for Elderly Gastric Cancer Patients |
| ZHU Hongkuan, CHEN Yonglun, LI Chao |
| Department of Anesthesiology, The First People's Hospital of Qujing, Yunnan Qujing 655000 |
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Abstract 【Objective】To explore the application of sevoflurane combined with propofol and remifentanil in elderly patients undergoing gastrectomy for gastric cancer.【Methods】A total of 100 elderly patients undergoing gastric cancer surgery at our hospital were randomly divided into two groups, with 50 patients in each group. The observation group received anesthesia with sevoflurane combined with remifentanil, while the control group received anesthesia with propofol combined with remifentanil. Vital signs, stress indicators, analgesic effects, postoperative recovery, and adverse reactions were compared between the two groups. 【Results】There were no significant differences in systolic blood pressure, diastolic blood pressure, and mean arterial pressure levels between the two groups before anesthesia induction (P>0.05). At the time of skin incision, the levels of all three indicators decreased compared to before induction in both groups (P<0.05), with even lower level in the control group than in the observation group (P<0.05). The levels of all three indicators rebounded at the time of extubation, but there were no significant differences between the two groups (P>0.05). Preoperative levels of cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) showed no significant differences between the two groups (P>0.05). During surgery, both indicators increased compared to before induction (P<0.05), with lower levels in the observation group than in the control group (P<0.05). The observation group had lower visual analogue scale (VAS) pain scores at 6 hours, 12 hours, and 24 hours postoperatively compared to the control group (P<0.05). The observation group also had shorter extubation time, awakening time, and time to resume out-of-bed activities compared to the control group (P<0.05). The incidence of adverse reactions in the observation group was lower than in the control group (P<0.05). 【Conclusion】Sevoflurane combined with remifentanil provides good anesthetic effects in elderly gastric cancer patients, with minimal impact on blood gases and stress indicators. It also offers a short awakening time, effective analgesia, and high safety.
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Received: 20 August 2023
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2024, Vol. 41 
