瑞芬太尼复合静吸全麻在老年患者手术麻醉中应用.docVIP

瑞芬太尼复合静吸全麻在老年患者手术麻醉中应用 　　【摘要】 目的：观察瑞芬太尼复合静吸在老年患者手术麻醉中的应用。方法：82例老年患者，使用瑞芬太尼复合静吸全麻，观察患者麻醉过程中的血压和心率变化，并记录患者术后睁眼时间、呼吸恢复时间和拔管时间。结果：瑞芬太尼复合静吸收缩压（SBP）在插管、切皮和手术1 h时明显低于基础值（P0.05），并且在各时点SBP和DBP比较差异均无统计学意义（均P0.05）。心率（HR）各时间点与基础值比较差异均无统计学意义（均P0.05）。患者睁眼时间为（5.9±2.2）s，呼吸恢复时间为（5.2±3.4）s，拔管时间为（8.3±2.3）s。结论：瑞芬太尼复合静吸在老年患者手术麻醉中患者血液动力学平稳，能达到较好的麻醉效果。 　　【关键词】 瑞芬太尼； 手术； 麻醉； 老年患者 　　中图分类号 R614.2 文献标识码 B 文章编号 1674-6805（2014）24-0133-02 　　Effect of Remifentanil Combined Intravenous and Inhalation Anesthesia in Elderly Patients for Surgical Anesthetic/HOU Xi-yong.//Chinese and Foreign Medical Research，2014，12（24）：133-134 　　【Abstract】 Objective：To observe the efficacy of Remifentanil combined intravenous and inhalation anesthesia in elderly patients for surgical anesthetic.Method：82 cases of elderly patients were administrated by Remifentanil combined intravenous and inhalation anesthesia.The changes of blood pressure and heart rate after administration were observed.The time of open eyes after surgery，breathing recovery and extubation were recorded.Result：SBP during intubation，incision and surgical 1 h were significantly lower than baseline（P0.05）.There were no different between each point in all time in SBP and DBP.Compared with baseline，there were no different in each time point in DBP.There had no significant effect on HR in all patients.The time of open eyes time was （5.9±2.2）s，breathing recovery was （5.2±3.4）s and extubation was （8.3±2.3）s.Conclusion：The hemadynamics was stable during surgery in elderly patients by Remifentanil combined intravenous and inhalation anesthesia，the efficacy of anesthesia was satisfied. 　　【Key words】 Remifentanil； Surgery； Anesthesia； Elderly patients 　　First-author’s address：The People’s Hospital of Lixin County，Lixin 236700，China 　　手术中由全麻诱导及插管拔管时引起的血液动力学变化极易导致在老年患者中产生具有较高风险的一系列并发症，而这些高风险并发症往往是由于老年人群中普遍较高的心血管疾病发病率所导致的，由于老年人群具有非典型性发病表现、生理功能相对低下、药效学和药代动力学易于改变和自主神经系统的变化等特点，因此在手术过程中鉴别老年患者的心血管相关的疾病较为困难[1]。同时老年患者在手术中对阿片类或其他麻醉药物较为敏感[2]。鉴于老年患者的潜在疾病和生理功能上的差异，在