摘要
目的探讨瑞芬太尼静脉麻醉在老年患者手术麻醉中的临床疗效及应用价值。方法将86例择期行腹部手术的老年患者随机分为观察组和对照组,观察组给予瑞芬太尼麻醉,对照组给予芬太尼麻醉。采用视觉模拟评分(VAS)评价术中产生的疼痛,比较两组患者术中各时间点血流动力学,以及苏醒时间、自主呼吸恢复时间、拔出导管时间、离开麻醉室时间和VAS。结果两组患者诱导后心率(HR)、收缩压(SBP)及舒张压(DBP)均显著低于诱导前,且插管后HR、SBP及DBP均显著高于诱导后;观察组插管后、手术开始时及术后1h的HR、SBP及DBP均显著低于对照组,差异有统计学意义。观察组苏醒时间、自主呼吸恢复时间、拔出导管时间及离开麻醉室的时间均显著短于对照组,且VAS显著低于对照组,差异有统计学意义。结论在老年患者手术麻醉中,瑞芬太尼能有效控制血流动力学,且起效快、恢复快、安全性高,其麻醉效果优于芬太尼,值得临床推广应用。
Objective To explore the clinical effects and application of remifentanil intravenous anesthesia in operative anesthesia of elderly patients. Methods Eighty-six elderly patients who would be subject to abdominal operation were randomly divided into observation group and control group. The patients in observation group were given remifentanil anesthesia, while those in control group were given fentanyl anesthesia. Visual analogue scale （VAS） was used to evaluate the intraoperative pain, and intraoperative haemodynamics at each time point,awakening time,autonomous respiration recovery time, time to take catheter and leave anesthetic room as well as VAS of patients were compared in two group. Results The heart rate, systolic blood pressure （SBP） and diastolic blood pressure （DBP） of patients after induction were significantly lower than those before induction in two groups, and HR,SBP and DBP after intubation markedly higher than those after induction. HR, SBP and DBP of patients after induction,at the beginning of operation and 1 h after operation in observation group were all remarkably lower than those in control group. The awakening time,autonomous respiration recovery time,time to take catheter and leave anesthetic room in observation group were significantly shorter than those in control group,and VAS was obviously lower than that of control group. Conclusion In operative anesthesia of elderly patients,remifentanil can effectively control haernodynamics,with rapid onset time and recovery as well as high safety. Its anesthetic effect is superior to that of fentanyl,being worthy of clinical popularization and application.
出处
《成都医学院学报》
CAS
2013年第3期338-340,共3页
Journal of Chengdu Medical College
基金
中国高校医学期刊临床专项资金项目(NO:11321055)
关键词
瑞芬太尼
静脉麻醉
老年
芬太尼
Remifentanil
Intravenous anesthesia
Elderly
Fentanyl
