CAJ | 학술논문

【目的】观察老年人经尿道前列腺电切手术中曲马多或芬太尼复合依托咪酯喉罩置入前后患者血流动力学的变化,从而探讨老年人喉罩麻醉下短小手术合适的诱导方式。【方法】选择本院经尿道前列腺电切手术患者80例,ASA Ⅰ~Ⅱ级,年龄为60~86岁,采用随机对照方法分为两组,每组40例,其中曲马多复合依托咪酯40例(曲马多组),芬太尼复合依托咪酯40例(芬太尼组)。记录比较麻醉诱导前、麻醉诱导后3 min 和成功放置喉罩后1 min、3 min 患者平均动脉压(MAP)、心率(HR)和血氧饱和度(SpO 2)的变化。【结果】曲马多组与芬太尼组诱导前 MAP,HR 的比较差异无显著性(P >0.05)；诱导后3 min、喉罩置入1 min、喉罩置入3 min 对应时间点 MAP,HR 较诱导前均明显下降,且差异有显著性(P <0.05)。芬太尼组诱导后3 min、喉罩置入1 min、喉罩置入3 min 对应时间点 MAP 与曲马多组比较下降更多,且差异有显著性(P <0.05)。诱导后3 min 芬太尼组的 HR 与曲马多组比较差异有显著性(P <0.05)；喉罩置入1 min、喉罩置入3 min 对应时间点两组 HR 的比较差异无显著性(P >0.05)。两组 SpO 2诱导前后比较差异均无显著性(P >0.05)。【结论】老年人喉罩麻醉诱导时采用曲马多复合依托咪酯与芬太尼复合依托咪酯比较对血流动力学影响小,循环更稳定。
【목적】관찰노년인경뇨도전렬선전절수술중곡마다혹분태니복합의탁미지후조치입전후환자혈류동역학적변화,종이탐토노년인후조마취하단소수술합괄적유도방식。【방법】선택본원경뇨도전렬선전절수술환자80례,ASA Ⅰ~Ⅱ급,년령위60~86세,채용수궤대조방법분위량조,매조40례,기중곡마다복합의탁미지40례(곡마다조),분태니복합의탁미지40례(분태니조)。기록비교마취유도전、마취유도후3 min 화성공방치후조후1 min、3 min 환자평균동맥압(MAP)、심솔(HR)화혈양포화도(SpO 2)적변화。【결과】곡마다조여분태니조유도전 MAP,HR 적비교차이무현저성(P >0.05)；유도후3 min、후조치입1 min、후조치입3 min 대응시간점 MAP,HR 교유도전균명현하강,차차이유현저성(P <0.05)。분태니조유도후3 min、후조치입1 min、후조치입3 min 대응시간점 MAP 여곡마다조비교하강경다,차차이유현저성(P <0.05)。유도후3 min 분태니조적 HR 여곡마다조비교차이유현저성(P <0.05)；후조치입1 min、후조치입3 min 대응시간점량조 HR 적비교차이무현저성(P >0.05)。량조 SpO 2유도전후비교차이균무현저성(P >0.05)。【결론】노년인후조마취유도시채용곡마다복합의탁미지여분태니복합의탁미지비교대혈류동역학영향소,순배경은정。
[Objective]To explore the hemodynamic changes of tramadol or fentanyl plus etomidate for elders during an anesthetic induction of laryngeal mask during transurethral resection of the prostate (TURP).[Methods]A total of 80 elders,aged 60~86 years and ASA grade Ⅰ~Ⅱ,undergoing TURP were random-ized into groups A (tramadol)and B (fentanyl)(n = 40 each).And the values of mean arterial pressure (MAP),heart rate (HR)and oxygen saturation (SpO 2 )before induction,after 3 min induction and after 1,3 min successful placement of laryngeal mask.[Results]For hemodynamic data,2-tailed t-test was used for in-tergroup comparison and repeated measures analysis of variance for intragroup comparison.At different time-points,MAP,HR and SpO 2 showed significant statistical differences (P < 0.05 ).HR and MAP declined compared with pre-induction.For MAP at 3 min of induction after 1 min,3 min successful placement of laryn-geal mask,tramadol and fentanyl anesthesia showed significant statistical difference (P <0.05).The tramad-ol group decreased to a smaller extent.For HR after 3 min induction,significant statistical difference existed (P <0.05).Also the tramadol group decreased to a smaller extent.[Conclusion]As compared with fentanyl, elderly patients with laryngeal mask using tramadol have a smaller hemodynamic impact.