The Effect Of Propofol And Sevoflurane On Early Gastrointestinal Motility In Patients Undergoing Laparoscopic Gynecological Surgery

Objective: To observe which anesthesia maintenance mode of propofol and sevoflurane can promote the early recovery of gastrointestinal function in patients undergoing laparoscopic gynecological surgery,so as to promote the recovery of patients and provide reference for clinical use.Method: This study protocol was conducted through the Ethics Committee of Yan’an University Affiliated Hospital.After obtaining written informed consent from patients and their families,102 patients who met the inclusion criteria for planned laparoscopic gynecological surgery from March to November 2022 were assigned to the propofol group(n=51)or the sevoflurane group(n=51)using computer-generated random numbers.After tracheal intubation of all patients with the same anesthesia induction scheme,propofol group was given continuous pump infusion of 4 ～6mg/kg/h propofol and 0.1 ～ 0.2 μg/kg/min remifentanil;Sevoflurane group received continuous inhalation of sevoflurane and continuous pumping of 0.1 ～ 0.2 μg/kg/min remifentanil,all patients had consistent intraoperative monitoring and postoperative pain relief plans.All surgeries are performed by the same group of surgeons.All nursing measures are consistent after the patient safely returns to the ward.Ultrasound scanning of the gastric antrum was performed on the patient in a semi supine position(45°)3 hours after surgery.Observe and record the frequency of gastric antral contraction(ACF),amplitude of gastric antral contraction(ACA),and gastric motility index(MI).Follow up patients’ postoperative pain scores,gastrointestinal recovery,and incidence of complications.Result: 1.After passing the inclusion and exclusion criteria,a total of 88 patients were included in this study.2.There were no statistically significant differences between the two groups in preoperative baseline characteristics,including age,BMI,and intraoperative conditions,including pneumoperitoneum time,anesthesia time,total intraoperative infusion volume,and intraoperative opioid consumption.3.Compared with the sevoflurane group,postoperative gastric antrum dynamics indexes,including frequency of gastric antrum contraction,amplitude of gastric antrum contraction and gastric motility index,were significantly increased in the propofol group(P < 0.05),and a higher proportion of patients recovered from early postoperative antrum motion in the propofol group(P < 0.05).4.There were no significant differences in the factors affecting the recovery of gastrointestinal function between the two groups,including the first time of getting out of bed,the time of urinary catheter retention and the level of postoperative blood potassium.5.Compared with the sevoflurane group,the postoperative gastrointestinal recovery of patients in the propofol group,including the recovery time of bowel sound,the first exhaust time,and the first solid consumption time,was significantly shortened(P <0.05),and the difference in the first postoperative defecation time was not statistically significant.6.Comparison of postoperative pain VAS score and incidence of complications,including nausea and vomiting,intestinal paralysis,postoperative abdominal distension,postoperative dizziness and lethargy,showed no statistical significance between the two patients.Conclusion: In laparoscopic gynecological short surgery,compared to sevoflurane,the anesthesia maintenance method mainly using propofol has a smaller impact on gastrointestinal motility function,and patients recover gastrointestinal function faster after surgery.