摘要
目的对比七氟烷和丙泊酚结合靶控输入瑞芬太尼对老年胃癌患者围麻醉期的影响。方法选取全身麻醉胃癌根治手术的老年患者158例,依据随机数字表法将其分成2组,观察组(79例)吸入七氟烷结合靶控输入瑞芬太尼麻醉,对照组(79例)靶控输入丙泊酚结合瑞芬太尼麻醉。观察麻醉诱导之前(T0)、患者切皮时(T1)、手术结束(T2)和拔管(T3)时HR、DP、SP、MAP和血压心率积(RPP),患者拔管时间、睁眼时间、使用血管活性药物和不良反应状况,采用视觉模拟评分(VAS)及Ramsay镇静评分检测患者术后6、12、24 h疼痛及镇静状况。结果观察组和对照组患者在T0、T1、T2、T3时间点内SP、DP、RPP、HR及MAP对比,差异均无统计学意义(P> 0. 05)。观察组患者睁眼、拔管时间低于对照组,差异有统计学意义(P <0. 05)。观察组血管活性药物使用率为21. 52%,对照组为25. 32%,差异无统计学意义(P>0. 05)。观察组患者术后6、12、24 h VAS评分及12、24 h镇静评分均低于对照组,差异有统计学意义(P <0. 05)。观察组不良反应发生率为21. 52%,对照组为18. 99%,差异无统计学意义(P> 0. 05)。结论丙泊酚或七氟烷联合靶控输注瑞芬太尼对老年胃癌患者麻醉效果与安全性均比较理想,但七氟烷联合瑞芬太尼麻醉患者术后清醒更快,术后疼痛改善更明显,临床应用价值更高。
Objective To compare the effects of seven halothane and propofol combined with target controlled infusion of remifentanil on elderly patients with gastric cancer during the perianesthesia.Methods A total of 158 elderly patients undergoing radical gastrectomy under general anesthesia were selected,then They were divided into two groups according to the random number table.Observation group(79 cases)was anesthetized with seven halothane combined with target controlled infusion,control group(79 cases)was anesthetized with propofol combined with target controlled infusion.HR,DP,SP,MAP and rate-pressure product(RPP)were observed before anesthesia induction(T0),at the time of patient curettage(T1),the end of surgery(T2)and extubation(T3),and the extubation time,eye opening time,use of vasoactive drugs and adverse reactions were observed.Visual analogue scale(VAS)and Ramsay sedation scale were used to detect postoperative pain and sedation of patients at 6,12 and24 h.Results There were no significant differences in SP,DP,RPP,HR and MAP between the observation group and the control group at T0,T1,T2 and T3(P>0.05);The eye opening time and extubation time of the observation group were lower than those of the control group(P<0.05);The usage rate vasoactive drugs of the observation group was 21.52%,and that of the control group was 25.32%(P>0.05).VAS scores at 6,12 and 24 h after surgery and sedation scores at 12 and 24 h after surgery of the observation group were lower than those of the control group(P<0.05).The incidence of adverse reactions of the observation group was 21.52%,and that of the control group was 18.99%(P>0.05).Conclusion Propofol and seven halothane combined with target controlled infusion of remifentanil has ideal effects on elderly patients with gastric cancer during the effect and Safety of anesthesia,but the patients during anesthesia with seven halothane combined with target controlled infusion is wake up faster after surgery,postoperative pain improve more significantly,and has higher clinical value.
作者
孙丽琼
梁晶晶
SUN Liqiong;LIANG Jingjing(The Third Hostipal of Mianyang,Mianyang,621000)
出处
《实用癌症杂志》
2019年第4期648-651,共4页
The Practical Journal of Cancer
关键词
老年胃癌手术
七氟烷
丙泊酚
瑞芬太尼
Geriatric gastric cancer surgery
Sevoflurane
Propofol
Remifentanil
