摘要
目的研究静吸复合麻醉联合脑电双频指数(BIS)监测在老年髋关节置换术早拔管中的应用价值。方法将60例髋关节置换术患者抽签随机分为观察组与对照组,每组30例,分别进行丙泊酚单纯麻醉诱导期和丙泊酚复合七氟烷麻醉诱导加维持观察,所有病人接受BIS监测,比较两组术中丙泊酚用量、BIS监测以及拔管时间差异,并对ICU拔管原因进行分析。结果入选病例均顺利完成实验,无一例出现围术期并发症和术中知晓,术后2周内均顺利出院。共有52例(86.25%)病例在手术室内拔管,拔管时间为术后25 min;病例诱导和插管时丙泊酚靶浓度显著低于丙泊酚复合七氟烷组,停用丙泊酚以及丙泊酚和七氟烷均停用的病例数恢复意识拔管时间组间比较差异无统计学意义(P>0.05),丙泊酚总剂量组间比较差异有统计学意义(P<0.05);ICU无法拔管原因则以经验不足、患者躁动及意识不清、术毕通气不足为主。结论 BIS监测下丙泊酚联合低流量七氟烷静吸复合麻醉用于老年患者髋关节置换术手术室内早拔管是可行的。
Objective To study the application value of intravenous inhalation anesthesia combined with BIS monitoring in elderly patients with hip replacement early extubation. Methods 60 cases of total hip replacement were randomly divided into observation group and control group, 30 cases of each group, which were respectively underwent propofol alone during induction of anesthesia and propofol combined with sevoflurane anesthesia induction and keep observing. All patients received the bispeetral index （BIS） monitoring. Propofol dosage and extubation time were compared between two groups, and analyzed the reason ICU of extubation. Results The selected patients were successfully completed the operation. There were no perioperative complications and intraoperative awakening, and were discharged at 2 weeks of postoperation. A total of 52 （86.25%） patients extubated in operating room, with extubation time of 25 minutes after operation ; case induction and intubation and propofol target concentration of propofol combined with seven isoflurane group was significantly lower than that of propofol and seven halothane. The number of discontinuation of propofol , discontinuation of propofol, halothane recover consciousness and extubation time were not significantly different between two groups （P 〉0.05） ; difference of total dose of propofol was statistically significant between two groups （P〈0.05）. The reason why ICU cannot extubate is lack of experience, patients with restless and unconsciousness, and anesthesia ventilation deficiency. Conclusion BIS monitoring of propofol combined with low flow of seven halothane Intravenous Inhalation Anesthesia for surgery in elderly patients with hip joint replacement indoor early extubation is feasible.
出处
《热带医学杂志》
CAS
2015年第7期939-942,共4页
Journal of Tropical Medicine
