七氟烷和丙泊酚在老年患者置入喉罩时合适浓度的临床研究.docVIP

七氟烷和丙泊酚在老年患者置入喉罩时合适浓度的临床研究 　　[摘要] 目的 探讨老年患者麻醉时七氟烷吸入、丙泊酚TCI在喉罩置入时的适宜浓度。 方法 将60例老年手术患者随机分成七氟烷组（S组）和丙泊酚组（P）组。按七氟烷吸入浓度，将S组分为SA组（5%七氟烷）、SB组（7%七氟烷）；按丙泊酚靶控输注（TCI）效应室浓度，将P组分为PA组（靶浓度2 μg/mL）、PB组（靶浓度3 μg/mL）。比较患者诱导前、置入喉罩前即刻、插入LMA后1 min和插入LMA后5 min MAP、HR和SpO2变化及相关并发症。结果 PB组的血压、心率显著低于PA组（P0.05）；SA、SB组在插入喉罩后血压、心率均有所升高，而SB组的血压、心率显著低于SA组。 结论 建议老年患者麻醉在丙泊酚TCI下置入喉罩，喉罩置入时丙泊酚效应室浓度为2 μg/mL；在七氟烷吸入诱导下置入喉罩时，七氟烷吸入浓度宜采用8%。 　　[关键词] 老年；喉罩；七氟烷；丙泊酚；靶控输注 　　[中图分类号] R726.1 [文献标识码] B [文章编号] 1673-9701（2014）33-0075-03 　　[Abstract] Objective To investigate the appropriate concentrations of sevoflurane inhalation and propofol target controlled infusion （TCI） in the elderly patients receiving laryngeal mask airway （LMA） insertion. Methods Sixty elderly surgical patients were randomly divided into the sevoflurane group （group S） and the propofol group （group P）. According to the inhalation concentration of sevoflurane， group S was divided into group SA （5% sevoflurane） and group SB （7% sevoflurane）； According to the effect compartment concentration of propofol TCI， group P was divided into group PA （target concentration of 2 μg/mL） and group PB （target concentration of 3 μg/mL）. The changes of MAP， HR and SpO2 and relevant complications before induction， immediately before LMA insertion， 1 minute after LMA insertion and 5 minutes after LMA insertion were compared. Results Group PB was significantly lower than group PA in the blood pressure and heart rate （P0.05）. After LMA insertion， the blood pressure and heart rates of group SA and SB increased， but the blood pressure and heart rate of group SB was significantly lower than those of group SA. Conclusion It is suggested that elderly patients receive laryngeal mask airway insertion under propofol TCI and the effect compartment concentration of propofol during laryngeal mask airway insertion be 2 μg/mL. When inserting laryngeal mask airway under sevoflurane inhalation induction， the appropriate inhalation concentration of sevoflurane is 8%. 　　[Key