摘要
目的观察瑞芬太尼联合丙泊酚辅助全身麻醉对老年手术患者拔管期心血管系统功能的影响。方法前瞻性研究。抽取2022年1月至2024年1月平顶山市第二人民医院收治的老年手术患者123例纳入研究,应用电脑随机分组法将入组患者分为常规组(61例)和联合组(62例)。常规组予以常规全身麻醉,联合组采用瑞芬太尼联合丙泊酚辅助全身麻醉,比较两组患者的麻醉恢复情况、拔管期血流动力学指标、手术应激情况及拔管不良事件发生情况。结果在不同麻醉方案下,联合组的术后睁眼时间、恢复自主呼吸时间、麻醉恢复室停留时间、拔管时间[(10.22±2.35)、(3.66±0.27)、(15.35±3.36)、(8.44±1.25)min]均低于常规组[(12.39±3.23)、(4.25±1.62)、(17.66±3.41)、(10.28±2.39)min],P均<0.05。拔管时及拔管后20 min,联合组心率及平均动脉压均低于常规组(P均<0.05)。术后,联合组去甲肾上腺素、皮质醇及血管紧张素水平均低于常规组(P均<0.05)。联合组的拔管期不良事件发生率(4.84%,3/62)低于常规组(19.67%,12/61),差异有统计学意义(P<0.05)。结论瑞芬太尼联合丙泊酚靶控输注可在不影响老年手术患者全身麻醉苏醒情况下有效稳定拔管期血流动力学,可减轻手术应激并降低拔管期不良事件的发生。
Objective To observe the effect of remifentanil combined with propofol assisted general anesthesia on cardiovascular system function during extubation in surgery for elderly patients.Methods A total of 123 elderly patients who underwent surgery in the Second People's Hospital of Pingdingshan from January 2022 to January 2024 were enrolled in the prospective study.And they were divided into a conventional group(61 cases)and a combination group(62 cases)using computer random grouping method.The conventional group was given conventional general anesthesia,while the combination group was given remifentanil combined with propofol assisted general anesthesia.The anesthesia recovery,hemodynamic indicators during extubation,surgical stress response,and incidence of adverse events during extubation of the two groups were compared.Results Under different anesthesia regimens,the postoperative eye opening time,spontaneous breathing recovery time,anesthesia recovery room stay time,and extubation time of the combination group were(10.22±2.35)minutes,(3.66±0.27)minutes,(15.35±3.36)minutes,and(8.44±1.25)minutes,which were lower than the(12.39±3.23)minutes,(4.25±1.62)minutes,(17.66±3.41)minutes,and(10.28±2.39)minutes of the conventional group(all P<0.05),correspondingly.During extubation and 20 minutes after extubation,the heart rate and mean arterial pressure of the combination group were lower than those of the conventional group(all P<0.05).The norepinephrine,cortisol and angiotensin I of the combination group were lower than those of the conventional group after treatment(all P<0.05).The incidence of adverse events during extubation in the combination group(4.84%,3/62)was lower than that in the conventional group(19.67%,12/61),P<0.05.Conclusions The controlled infusion of remifentanil combined with propofol can effectively stabilize the hemodynamics during extubation without affecting the general anesthesia recovery in surgery of elderly patients.It has a positive significance in reducing surgical stress response and decreasing the risk of adverse events during extubation.
作者
姚玲玲
郭鹏飞
Yao Lingling;Guo Pengfei(Department of Anesthesia Surgical,the Second People's Hospital of Pingdingshan,Pingdingshan 467000,China;Department of Anesthesiology,Pingdingshan First People's Hospital,Pingdingshan 467000,China)
出处
《中国实用医刊》
2024年第17期44-48,共5页
Chinese Journal of Practical Medicine
关键词
老年人
手术
瑞芬太尼
丙泊酚
拔管期
心血管系统
Aged
Surgery
Remifentanil
Propofol
Extubation period
Cardiovascular system
