老年肿瘤手术患者在全凭静脉麻醉拔管期应用布托啡诺对心血管反应的影响  

Elderly Patients with Tumors in the TIVA Extubation Application Butorphanol Cardiovascular Responses

作　　者：王海东[1] 徐维安[1] 李向前[1] 王鸿旻[1] 何平[1] 

机构地区：[1]甘肃省肿瘤医院麻醉科,甘肃兰州730050

出　　处：《中国医药指南》2012年第25期12-14,共3页Guide of China Medicine

摘　　要：目的观察老年肿瘤手术患者拔管前静脉注射布托啡诺对拔管期间心血管反应的抑制效应及血氧饱和度的影响。方法选择ASAⅡ～Ⅲ级择期老年肿瘤手术患者60例随机分成布托啡诺组(A组)和对照组(B组)。麻醉维持药于术毕前25min停止泵入芬太尼和维库溴铵,术毕前10min停止泵入丙泊酚,A组于术毕前10min静注20μg/kg布托啡诺,B组不给药。观察两组患者在注射前(T0)、吸痰时(T1)、拔管时(T2)和拔管后1 min(T3)、拔管后5 min(T4)的血压,心率、血氧饱和度、全麻清醒时间、躁动发生情况。结果 A组在吸痰时、拔管时和拔管后1min、5min的收缩压、舒张压,心率与注射前的相比略有升高,呼吸平稳,血氧饱和度变化不明显。B组在吸痰时、拔管时和拔管后1min的收缩压、舒张压、心率均有明显的升高(P<0.01),拔管后5min稍有下降但仍高于注射前。两组患者在拔管时间、清醒时间比较差异均无统计学意义。结论在术毕前10min静注布托啡诺能有效减轻老年肿瘤患者在全凭静脉麻醉后拔管期内的心血管副反应,使其平稳度过拔管期,降低老年肿瘤患者的围术期心血管意外的发生概率。Objective Observe the inhibitory effect of the cardiovascular response and the influence of the oxygen saturation during extubation to the elderly patients with cancer surgery who extubate before intravenous butorphanol.Methods Choose 60 ASA II-III elective elderly patients with cancer surgery and randomly divided into Group Butorphanol（Group A） and Control Group（Group B）.Stop injecting Fentanyl Vecuronium 25 minutes before the end of the surgery,Propofel 10 minutes before the end of the surgery.Inject 20μg /kg Butorphanol 25 minutes before the end of the surgery for Group A and no more medicine for Group B.Observe the blood pressure,heart rate,oxygen saturation,anesthesia wake time and the condition of agitation of the two groups＇ patients before injection（T0）,suction（T1）,extubation（T2） and 1 minute after extubation（T3）,5 minutes after extubation（T4）.Results The systolic blood pressure,diastolic blood pressure and heart rate of Group A when suction,extubation and 1 minute,5 minutes after extubation are slightly higher than the data before injection.Respiratory smoothly,Oxygen saturation do not change so significantly.The systolic blood pressure,diastolic blood pressure and heart rate of Group B when suction,extubation and 1 minute after extubation are significantly higher than the data before injection（P0.01）,and decrease slightly 5 minutes after extubation,but still higher than the data before the injection.The differences of extubation time and wake time between the two groups have no sense of statistics.Conclusion Intravenos injection of butorphanol 10 minutes before the end of the surgery can effectively reduce the cardiovascular side effects caused by intravenos anesthesia in eiderly cancer patients,make the extubation period smooth and effectively reduce the risk of cardiovascular during perioperative.

关 键 词：全凭静脉麻醉 布托啡诺 心血管反应 

分 类 号：R714.252[医药卫生—妇产科学]