摘要
目的 探讨瑞芬太尼复合小剂量丙泊酚在老年患者开胸手术中的应用.方法 选择ASAⅠ或Ⅱ级择期行开胸手术老年患者80例,随机分为吸入麻醉组（A组）和静脉麻醉组（B组）,均行硬膜外阻滞.记录入室（T0）、麻醉诱导后（T1）、气管插管时（T2）、切皮时（T3）、切皮后30 min（T4）、切皮后60 min（T5）、切皮后90 min（T6）、拔管时（T7）的平均动脉压（MAP）、心率（HR）、脑电双频指数（BIS）;记录停药后患者自主呼吸恢复时间、吞咽时间、呼之睁眼时间、拔管时间及拔管时意识和躁动情况;术后随访有无术中知晓.结果 A、B组MAP、HR、BIS仅在T7时间点比较差异有统计学意义（P〈0.05）;停药后B组围苏醒时间短、意识恢复好、躁动发生率低;两组均无术中知晓.结论 0.05-0.10 μg/（kg·h）瑞芬太尼复合3 mg/（kg·h）丙泊酚用于老年患者开胸手术麻醉安全有效,无术中知晓.
Objective To investigate the application of low dose of propofol-remifentanil in elderly patients undergoing thoracic surgery.Methods Eighty elderly patients（ASA Ⅰor Ⅱ） scheduled for elective thoracic surgery were randomly divided into two groups： group A with inhalational sevoflurane and group B with infusing propofol-remifentanil.All patients received epidural block.MAP,HR and BIS were recorded when entering the operating room（T0）,anesthetic induction（T1）,intubation（T2）,beginning of operation（T3）,30 min after beginning of operation（T4）,60 min after beginning of operation（T5）,90 min after beginning of operation（T6） and extubation（T7）.The recovery of independent respiration time,deglutation time,eye opening time upon calling,extubation time,the recovery of orientation force time after the drug withdrawal were recorded.Consciousness and restlessness of extubation were observed.Awareness of after operation was followed up.Results There was no significant difference in MAP,HR and BIS between group A and group B except for the time of extubation（P〈0.05）.Compared with group A,the recovery of independent respiration time,deglutation time,eye opening time upon calling,extubation time,the recovery of orientation force time and leaving the operating room time after the drug withdrawal significantly decreased in group B（P〈0.05）.Consciousness and restlessness of extubation were significantly better in group B than that in group A（P〈0.05）.All patients had no awareness.Conclusions Combined with epidural block,remifentanil infused at a rate of 0.05-0.10 μg/（kg·h） and propofol infused at a rate of 3 mg/（kg·h） for total intravenous anesthesia is safe and efficacious in elderly patients undergoing thoracic surgery.
出处
《中国实用医刊》
2017年第10期84-87,共4页
Chinese Journal of Practical Medicine
基金
河南省科技厅资助项目（122300410068）
关键词
瑞芬太尼
丙泊酚
老年患者
开胸手术
Remifentanil
Propofol
Elderly patients
Thoracic surgery
