老年高血压患者术中靶控输注依托咪酯与丙泊酚的临床观察  

Application of Etomidate or Propofol Target Controlled Infusion in the Elderly Hypertensive Patients

作　　者：卢丽雅[1] 

机构地区：[1]广州医学院第一附属医院麻醉科,广东省广州市510120

出　　处：《实用心脑肺血管病杂志》2012年第8期1283-1285,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的对比观察老年高血压患者术中靶控输注依托咪酯、丙泊酚对血流动力学及术毕苏醒的影响。方法择期行腹腔镜手术老年高血压患者60例,随机分为依托咪酯组(E组)和丙泊酚组(P组),每组30例。E组靶控输注依托咪酯和复合瑞芬太尼进行麻醉诱导并维持,P组靶控输注丙泊酚和复合瑞芬太尼诱导并维持。记录麻醉前(T0)、插管前1 min(T1)、插管后2 min(T2)、置入腹腔镜后3 min(T3)、手术探查后3 min(T4)、拔管后3 min(T5)等6个时点的收缩压(SBP)、舒张压(DBP)和心率(HR)及苏醒指标、不良反应等。结果与T0比较,T1时点,SBP、DBP、HR均显著降低(P<0.05);且P组较E组显著下降(P<0.05);T3时点P组HR显著减慢(P<0.01)。两组不良反应发生率无统计学差异(P>0.05)。E组苏醒时间均明显长于P组(P<0.05)。结论 E组与P组比较,靶控输注依托咪酯更有利于老年高血压患者血流动力学稳定,但苏醒时间延长。Objective To compare with the effects of etomidate or propofol target controlled infusion （TCI） on hemo-dynamics and recovery in the elderly hypertensive patients. Methods Sixty elderly hypertensive patients with underwent laparo-seopic operation were randomized into etomidate group （Group E） and propofol group （Group P）, each group was 30 cases. Patients in Group E were induced and maintained with TCI etomidate and remifentanil, patients in Group P were induced and maintained with TCI propofol and remifentanil. The systolic blood pressure （ SBP）, diastolic blood pressure （ DBP）, heart rate （HR）, recovery time index and adverse reaction were recorded before anesthesia induction （T0）, 1 min before tracheal intaba-tion （T1） , 2 min after tracheal intubation （T2）, 3 rain after insert laparoseope （T3）, 3 rain after exploration （T4） and 3 min after tracheal extubation （T5） respectively. Results Compared with TO, SBP, DBP and HR decreased significantly in both groups at time T1 （P 〈 0. 05 ） ; but group E has a better hemodynamics than group P （ P 〈 0. 05 ） ; HR in group P de- creased significantly at time T3 （P 〈0. 01 ）. There was no any significant difference in the side effect rate （P 〉0. 05）. The re-covery time in group E was longer than that of group P （ P 〈 0. 05 ）. Conclusion Group E is easier to maintain stable hemody-namics than group P, but the recovery time may be prolonged in the elderly hypertensive patients.

关 键 词：靶控输注 依托咪酯 丙泊酚 高血压 老年人 

分 类 号：R544.1[医药卫生—心血管疾病]