中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2011年
4期
507-509
,共3页
依托咪酯%瑞芬太尼%全身麻醉%老年患者
依託咪酯%瑞芬太尼%全身痳醉%老年患者
의탁미지%서분태니%전신마취%노년환자
Etomidate%Remifentanil%General anesthesia%Elderly patients
目的 探讨依托咪酯乳剂复合瑞芬太尼麻醉用于老年患者的效果、安全性和可行性.方法 择期腹部全麻手术的老年患者40例,随机分为两组,即依托咪酯乳剂组(A组)和丙泊酚组(B组).麻醉诱导:咪达唑仑0.04 mg/kg,瑞芬太尼1.5μg/kg(时间＞60 s),阿曲库铵0.6 mg/kg,A组依托咪酯乳剂0.2 mg/kg(30～60 s),B组丙泊酚1.5 mg/kg(30～60 s).麻醉维持:A组微量泵静脉持续泵入依托咪酯乳剂0.6～1.2 mg·kg-1·h-1和瑞芬太尼12～15μg·kg-1·h-1,维持BIS值40～60;B组微量泵静脉持续泵入丙泊酚6～10 mg·kg-1·h-1和瑞芬太尼12～15μg·kg-1·h-1,维持BIS值40～60.观察记录两种静脉复合麻醉用于老年患者麻醉前(T1)、气管插管前1 min(T2)、气管插管后1 min(T3)、切皮后5 min(T4)、探查后5 min(T5)、病灶切下后5 min(T6)、拔除气管导管后3 min(T7)、术后30 min(T8)的SBP、DBP、HR;同时记录两组患者停药后苏醒时间、拔管时间、恢复时间和术后随访术中知晓以及麻醉满意度.结果 B组T2、T3、T4、T5的SBP、DBP和T6的DBP均明显低于A组(均P＜0.05),B组T3和T7的HR均明显低于A组(均P＜0.05);与麻醉前相比,B组T2、T3、T4、T5的SBP、DBP和T6的DBP均明显降低(均P＜0.05),B组T2的HR下降明显(P＜0.05),A组拔管后的HR明显加快(P＜0.05).B组苏醒时间、拔管时间均明显低于A组(均P＜0.05).两组术后满意度差异无统计学意义(P＞0.05),均无术中知晓发生.结论 依托咪酯复合瑞芬太尼麻醉对老年患者循环系统影响轻,血流动力学更平稳,比丙泊酚复合瑞芬太尼更适合用于老年患者.
目的 探討依託咪酯乳劑複閤瑞芬太尼痳醉用于老年患者的效果、安全性和可行性.方法 擇期腹部全痳手術的老年患者40例,隨機分為兩組,即依託咪酯乳劑組(A組)和丙泊酚組(B組).痳醉誘導:咪達唑崙0.04 mg/kg,瑞芬太尼1.5μg/kg(時間＞60 s),阿麯庫銨0.6 mg/kg,A組依託咪酯乳劑0.2 mg/kg(30～60 s),B組丙泊酚1.5 mg/kg(30～60 s).痳醉維持:A組微量泵靜脈持續泵入依託咪酯乳劑0.6～1.2 mg·kg-1·h-1和瑞芬太尼12～15μg·kg-1·h-1,維持BIS值40～60;B組微量泵靜脈持續泵入丙泊酚6～10 mg·kg-1·h-1和瑞芬太尼12～15μg·kg-1·h-1,維持BIS值40～60.觀察記錄兩種靜脈複閤痳醉用于老年患者痳醉前(T1)、氣管插管前1 min(T2)、氣管插管後1 min(T3)、切皮後5 min(T4)、探查後5 min(T5)、病竈切下後5 min(T6)、拔除氣管導管後3 min(T7)、術後30 min(T8)的SBP、DBP、HR;同時記錄兩組患者停藥後囌醒時間、拔管時間、恢複時間和術後隨訪術中知曉以及痳醉滿意度.結果 B組T2、T3、T4、T5的SBP、DBP和T6的DBP均明顯低于A組(均P＜0.05),B組T3和T7的HR均明顯低于A組(均P＜0.05);與痳醉前相比,B組T2、T3、T4、T5的SBP、DBP和T6的DBP均明顯降低(均P＜0.05),B組T2的HR下降明顯(P＜0.05),A組拔管後的HR明顯加快(P＜0.05).B組囌醒時間、拔管時間均明顯低于A組(均P＜0.05).兩組術後滿意度差異無統計學意義(P＞0.05),均無術中知曉髮生.結論 依託咪酯複閤瑞芬太尼痳醉對老年患者循環繫統影響輕,血流動力學更平穩,比丙泊酚複閤瑞芬太尼更適閤用于老年患者.
목적 탐토의탁미지유제복합서분태니마취용우노년환자적효과、안전성화가행성.방법 택기복부전마수술적노년환자40례,수궤분위량조,즉의탁미지유제조(A조)화병박분조(B조).마취유도:미체서륜0.04 mg/kg,서분태니1.5μg/kg(시간＞60 s),아곡고안0.6 mg/kg,A조의탁미지유제0.2 mg/kg(30～60 s),B조병박분1.5 mg/kg(30～60 s).마취유지:A조미량빙정맥지속빙입의탁미지유제0.6～1.2 mg·kg-1·h-1화서분태니12～15μg·kg-1·h-1,유지BIS치40～60;B조미량빙정맥지속빙입병박분6～10 mg·kg-1·h-1화서분태니12～15μg·kg-1·h-1,유지BIS치40～60.관찰기록량충정맥복합마취용우노년환자마취전(T1)、기관삽관전1 min(T2)、기관삽관후1 min(T3)、절피후5 min(T4)、탐사후5 min(T5)、병조절하후5 min(T6)、발제기관도관후3 min(T7)、술후30 min(T8)적SBP、DBP、HR;동시기록량조환자정약후소성시간、발관시간、회복시간화술후수방술중지효이급마취만의도.결과 B조T2、T3、T4、T5적SBP、DBP화T6적DBP균명현저우A조(균P＜0.05),B조T3화T7적HR균명현저우A조(균P＜0.05);여마취전상비,B조T2、T3、T4、T5적SBP、DBP화T6적DBP균명현강저(균P＜0.05),B조T2적HR하강명현(P＜0.05),A조발관후적HR명현가쾌(P＜0.05).B조소성시간、발관시간균명현저우A조(균P＜0.05).량조술후만의도차이무통계학의의(P＞0.05),균무술중지효발생.결론 의탁미지복합서분태니마취대노년환자순배계통영향경,혈류동역학경평은,비병박분복합서분태니경괄합용우노년환자.
Objective To study the anesthesia effect,safety and reliability of etomidate combined with remifentanil in elderly patients. Methods 40 patients scheduled for abdominal operation were divided into two groups with 20 cases each: etomidate group(group A)and propofol group(group B).Anesthesia induction: midazolam 0.04mg/kg,remifentanil 1.5 μg/kg(time＞60s),atracurium 0.6mg/kg,group A to etomidate 0.2mg/kg(30 ～ 60s),(T1),1 min before trachea intubation(T2),1 min after trachea intubation(T3),5 min after cutting skin(T4),5 min after exploration(T5),5min after cutting ill focus(T6),3min after tracheal extubation(T7),30min after operation(T8).At the same time,observed analepsia condition. Results In group B,SBP and DBP were lower than those in group A at T2,T3,T4 and T5(all P＜0.05).In group B,DBP was lower than those in group A at T6 and HR was lower than those in group A at T3 and T7(all P＜0.05).In group B,SBP and DBP were lower than before anesthesia at T2,T3,T4 and T5(all P＜0.05).In group B,DBP was lower than before anesthesia at T6 and HR was lower than before anesthesia at T2(all P＜0.05).In group A,HR was faster than before anesthesia at T7(P＜0.05).The time of openingeyes,remove-tracheal tube in B group was less than those in A group(all P＜0.05).Both groups without memory about operation,anesthesia was content. Conclusion Etomidate combined with remifentanil anesthesia was milder than propofol group to elderly patients ardiovascular effects.It was better than propofol group for elderly patients.
