靶控输注瑞芬太尼复合七氟醚吸入麻醉用于老年肿瘤患者的临床评价  

Evaluation of target controlled infusion of remifentanil combined with sevoflurane or with propofol of target controlled infusion in the elderly patients with tumor

作　　者：熊章荣[1] 蒋燕[1] 邓永乐[1] 唐延先[1] 

机构地区：[1]重庆市肿瘤研究所麻醉科,400030

出　　处：《重庆医学》2011年第3期266-268,共3页Chongqing medicine

摘　　要：目的比较靶控输注（target controlled infusion,TCI）瑞芬太尼复合七氟醚吸入与复合丙泊酚靶控用于老年肿瘤患者的麻醉效果和麻醉恢复情况。方法选择年龄65~80岁,美国麻醉师协会（ASA）Ⅰ~Ⅱ级,拟在全麻下行胃癌、直肠癌、结肠癌手术的患者96例,随机分为两组：七氟醚组（S组,n=48）和丙泊酚组（P组,n=48）,术中监测脑电双频指数（bispectral index,BIS）,观察患者麻醉诱导前（T0）、切皮时（T1）、术毕（T2）及拔管时（T3）的心率、血压和二重指数（RPP）,记录术毕患者睁眼时间和拔管时间。结果两组患者在相同麻醉深度下,即BIS术中维持在40~60,各时间点血压、心率和RPP两组比较差异均无统计学意义（P〉0.05）;但与丙泊酚组比较,七氟醚组患者睁眼时间和拔管时间明显缩短（P〈0.05）。结论靶控输注瑞芬太尼复合七氟醚吸入与复合丙泊酚靶控用于老年肿瘤患者均安全有效,且不增加其心肌缺血的风险,但复合七氟醚吸入患者苏醒更快。Objective To study the effects of target-controlled infusion（TCI）of remifentanil combined with sevoflurane or with propofol of target controlled infusion in the elderly patients with tumor on anesthetic outcome and post-anesthetic recovery.Methods 96 patients aged 65-80,ASA physical status Ⅰ-Ⅱ,scheduled for gastrectomy or rectal surgery was randomly allocated to either sevofluane（S,n=48） or propofol（P,n=48） group.The following data were recorded and analyzed：the bispectral index（BIS）,the time of eyes opening and extubation,blood pressure（BP）and heart rate（HR）before anesthesia（T0）,the beginning（T1）and end of surgery（T2）,and the time point of extubation（T3）.The rate pressure product（RPP）at each measuring time point was calculated.Results In the same depth of anesthesia which bispectral index（BIS）controlled 40-60,there were no significant differences in BP,HR and RPP at every time point observed between the two groups（P0.05）.Compared with group P,eyes opening time and extubation time were significantly decreaed in group S（P0.05）.Conclusion It is safe that target-controlled infusion（TCI）of remifentanil combined with sevoflurane or with propofol applicated in the elderly patients with tumor.Myocardial ischemia do not occur in the depth of anesthesia.And the faster wake up are found in group S compared with group P.

关 键 词：麻醉 靶控输注 瑞芬太尼 七氟醚 丙泊酚 老年肿瘤患者 

分 类 号：R614[医药卫生—麻醉学]