摘要
目的:探讨瑞芬太尼复合丙泊酚应用于老年骨科手术患者的麻醉效果。方法:选取进行骨科手术的老年患者102例,随机分为观察组和对照组各51例,均给予全身静脉麻醉,观察组予瑞芬太尼复合丙泊酚,对照组予芬太尼复合丙泊酚。比较T0(麻醉诱导前)、T1(麻醉诱导后)、T2(手术开始时)、T3(手术结束时)血流动力学指标,术前、术后24 h炎性因子水平,术后苏醒时间及拔管时间。结果:T1、T2时观察组血压分别为(91.89±8.93)、(102.36±8.93) mmHg,明显下降且低于对照组(P<0.05),而心率无明显变化(P>0.05),2组术前炎性因子水平差异无统计学意义(P>0.05),术后24 h TNF-α[(42.62±10.02) mg/mL]、IL-6[(36.21±5.27) pg/mL]、hs-CRP[(5.19±0.72) mg/mL]指标水平均提高,各炎症因子水平低于对照组(P<0.05),观察组苏醒时间、拔管时间均短于对照组(P<0.05)。结论:瑞芬太尼复合丙泊酚应用于老年骨科手术患者镇静镇痛效果显著,术后苏醒快,减轻炎症反应,促进术后恢复,建议在临床上推广。
Objective:To investigate the effect of remifentanil combined with propofol in elderly patients undergoing orthopedic surgery. Methods: 102 elderly patients who underwent orthopedic surgery in our hospital were divided into experimental group and control group. All patients were given intravenous anesthesia. Remifentanil combined with propofol in the experimental group, and fentanyl combined with propofol in the control group. Comparing T0 (before induction of anesthesia), T1 (after induction of anesthesia), T2 (at the beginning of surgery), T3 (at the end of surgery), hemodynamic parameters, inflammatory factor levels 24 hours before and after the surgery, postoperative recovery time and extubation time. Results: At T1 and T2, the blood pressure of the observation group decreased significantly, and was lower than that of the control group (P<0.05), but there was no significant change in heart rate (P>0.05). There was no significant difference in the preoperative inflammatory factor level. The Levels TNF-α,IL-6 and hs-CRP were significantly increased, and the increase of the control group was more significant (P<0.05). The recovery time and extubation time of the experimental group were significantly shorter (P<0.05). Conclusion: Remifentanil combined with propofol is effective in elderly patients undergoing orthopedic surgery for sedative analgesia, rapid recovery after surgery. It also relieves inflammation and promotes postoperative recovery. Therefore, it is recommended for clinical promotion.
作者
班荣球
Ban Rongqiu(The First people’s Hospital of Hechi)
出处
《长治医学院学报》
2019年第2期123-126,共4页
Journal of Changzhi Medical College
关键词
瑞芬太尼
芬太尼
丙泊酚
骨科手术
老年患者
remifentanil
fentanyl
propofol
orthopedic surgery
elderly patients
