CAJ | 학술논문

目的比较麻黄碱预处理,小剂量顺苯磺酸阿曲库铵预注以及二者联用对老年患者顺苯磺酸阿曲库铵起效时间和血流动力学的影响.方法气管内插管全身麻醉下手术的老年患者60例,应用随机数字表法分为4组:麻黄碱组(E组)、小剂量顺苯磺酸阿曲库铵预注组(P组)、麻黄碱预处理复合小剂量顺苯磺酸阿曲库铵预注组(PE组)、对照组(C组),每组各15例.P组和PE组静脉注射顺苯磺酸阿曲库铵0.015 mg/kg.E组和PE组静脉注射麻黄碱70 μg/kg.靶控输注异丙酚,静脉注射芬太尼诱导.随后E组和C组静脉注射顺苯磺酸阿曲库铵插管剂量0.15 mg/kg,P组和PE组静脉注射剩余插管剂量.待肌颤搐反应消失后行气管插管.结果 PE、C、E、P组起效时间[(164±28)s、(306±61)s、(187±31)s、(193±40)s比较差异有统计学意义,F=33.990,P＜0.01],PE组的起效时间明显短于C组、E组和P组且差异均有统计学意义(P＜0.01,P＜0.05).诱导后各组收缩压(SBP)(F组内=35.783,P=0.000)、平均动脉压(MAP)(F组内=30.015,P=0.000)与同组诱导前比较均显著下降;PE组的SBP、舒张压(DBP)、MAP均显著高于C组(P均＜0.05);E组的SBP、DBP、MAP也显著高于C组(P均＜0.05);诱导后PE组和C组的心率(HR)比较差异有有统计学意义(P＜0.05),C组HR较诱导前显著下降(P＜0.05).诱导后血压降低C组有11例,P组有10例,而E组和PE组各有5例和4例,差异有统计学意义(x2 =9.867,P＜0.05).插管后血压升高E组有5例,PE组和P组各有4例,C组有3例,差异无统计学意义(x2=0.682,P＞0.05).结论 70 μg/kg的麻黄碱可缓解老年患者异丙酚诱导时的循环抑制,复合小剂量顺苯磺酸阿曲库铵预注可进一步缩短其起效时间,适合于老年人.
목적 비교마황감예처리,소제량순분광산아곡고안예주이급이자련용대노년환자순분광산아곡고안기효시간화혈류동역학적영향.방법 기관내삽관전신마취하수술적노년환자60례,응용수궤수자표법분위4조:마황감조(E조)、소제량순분광산아곡고안예주조(P조)、마황감예처리복합소제량순분광산아곡고안예주조(PE조)、대조조(C조),매조각15례.P조화PE조정맥주사순분광산아곡고안0.015 mg/kg.E조화PE조정맥주사마황감70 μg/kg.파공수주이병분,정맥주사분태니유도.수후E조화C조정맥주사순분광산아곡고안삽관제량0.15 mg/kg,P조화PE조정맥주사잉여삽관제량.대기전휵반응소실후행기관삽관.결과 PE、C、E、P조기효시간[(164±28)s、(306±61)s、(187±31)s、(193±40)s비교차이유통계학의의,F=33.990,P＜0.01],PE조적기효시간명현단우C조、E조화P조차차이균유통계학의의(P＜0.01,P＜0.05).유도후각조수축압(SBP)(F조내=35.783,P=0.000)、평균동맥압(MAP)(F조내=30.015,P=0.000)여동조유도전비교균현저하강;PE조적SBP、서장압(DBP)、MAP균현저고우C조(P균＜0.05);E조적SBP、DBP、MAP야현저고우C조(P균＜0.05);유도후PE조화C조적심솔(HR)비교차이유유통계학의의(P＜0.05),C조HR교유도전현저하강(P＜0.05).유도후혈압강저C조유11례,P조유10례,이E조화PE조각유5례화4례,차이유통계학의의(x2 =9.867,P＜0.05).삽관후혈압승고E조유5례,PE조화P조각유4례,C조유3례,차이무통계학의의(x2=0.682,P＞0.05).결론 70 μg/kg적마황감가완해노년환자이병분유도시적순배억제,복합소제량순분광산아곡고안예주가진일보축단기기효시간,괄합우노년인.
Objective To compare the effects of Ephedrine and combined with small dose cisatracurium treatments on the onset time of cisatracurium and hemodynamics in elderly patients.Methods Sixty cases of elderly patients undergoing elective surgery under general anesthesia were randomly divided into 4 groups:E group (ephedrine pretreatment),P group (cisatracurium primin),PE group (cisatracurium priming and ephedrine pretreatment) and C group(control),and each group of 15 cases.Cisatracurium 0.15 mg/kg were given in P group and PE group,and then ephedrine 70 μg/kg were given in PE group and E group.Anesthesia was induced with target controlled infusion of propofol (target plasma concentration 3-5 pg/ml),fentanyl 3-4 pg/kg.Cisatracurium 0.015 mg/kg were given in E group and C group,and P group and PE group dose intravenous cannula remaining.Tracheal intubation was performed when the twitch height depressed to 0.Results The Onset time of PE,C,E and P group were (164±28) s,(306±61) s,(187±31) s and (193±40) s and there were significant differences(F=33.990,P＜0.01).The onset time of PE group was shorter than that in C,E,P group,and the difference was significant (P＜0.05).Systolic pressure (SBP) and mean arterial pressure (MAP) levels in four groups after induction were lower than those before induction (F =35.783,30.015,P =0.000).SBP,diastolic blood pressure (DBP),MAP in PE group and E group were significant higher than those in C group(P＜0.05).After inductions,heart rate(HR) in PE group was significant different form that in C group(P ＜0.05),and HR of C group was significantly decrease than before inductions(P＜0.05).After inductions,the cases with DBP were 11 patients(73.3％) in C group,10 patients(66.7％) in P group:,5 patients(33.3％) in E group,and 4 patients (26.7％) in PE group,the different were significant (x2 =9.867,P ＜ 0.05).After intubation,cases with increase blood press were 3 patients (20.0％) in C group,5 patients(33.3％) in E group,and 4 patients(26.7％) in E group and PE group(P＞0.05).Conclusion Ephedrine of 70 μg/kg can relief the circulatory depression and accelerate the onset time of cisatracurium in the elderly patients.Combined with cisatracurium priming can further shorten the onset time and be for elders.