七氟醚吸入麻醉在老年患者经直肠前列腺穿刺活检术中的应用  

Evaluation of sevoflurane inhalation anesthesia in elderly men undergoing transrectal ultrasound-guided prostate biopsy

作　　者：李倩[1] 李荣[1] 毛洪雅 胡娜[1] 张中军[1] 

机构地区：[1]无锡市第三人民医院麻醉科,214041

出　　处：《临床麻醉学杂志》2016年第10期966-968,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨七氟醚吸入麻醉应用于老年患者经直肠前列腺穿刺活检术的安全性及对术后短期认知功能的影响。方法选择经直肠前列腺行穿刺活检术患者100例,年龄65~80岁,ASAⅠ或Ⅱ级。随机分为七氟醚组（S组）和丙泊酚组（P组）,每组50例,分别采用七氟醚吸入麻醉和丙泊酚静脉麻醉,均行12针穿刺。记录麻醉前（T0）、麻醉后即刻（T1）、术中（T2）、术毕即刻（T3）的MAP、HR,记录患者入睡时间、唤醒时间;于麻醉前和术后30min采用简易智能精神状态检查量表（MMSE）行认知功能检查;记录术中低血压、心动过缓、呼吸抑制和体动的发生情况。结果与T0时比较,T1时两组患者MAP明显降低,P组HR明显减慢（P〈0.05）;与T1时比较,T2、T3时两组患者MAP明显升高,P组HR明显增快（P〈0.05）;T1时P组HR明显慢于S组（P〈0.05）。两组患者入睡时间、唤醒时间差异无统计学意义。与麻醉前比较,术后30min P组MMSE评分明显降低且明显低于S组（P〈0.05）。S组术中心动过缓及体动发生率明显低于P组（P〈0.05）,呼吸抑制发生率低于P组。结论与丙泊酚静脉麻醉比较,七氟醚吸入麻醉用于经直肠前列腺穿刺活检术,对呼吸循环及术后短期认知功能影响小。Objective To investigate safety and early recovery of postoperative cognitive function in patients who underwent transrectal ultrasound-guided prostate biopsy under sevoflurane inhalation anesthesia.Methods One hundred patients,aged 65-80 years and falling into ASA gradeⅠ orⅡ catergory were randomly divided into two groups according to the way of anesthesia.Fifty cases in sevoflurane inhalation anesthesia group（group S）and fifty cases in propofol intravenous anesthesia group（group P）.The clinical data were recorded regarding MAP,HR before induction（T0）,at the moment of induction（T1）,intra operation（T2）and right after the operation（T3）,respectively,as well as the time of falling asleep and awakening up and adverse reaction.All patients received minimental state examination（MMSE）test pre-anesthesia and 30 min after operation.Results Compared with T0,MAP of two groups and HR of group P were significantly decreased on T1（P〈0.05）.Compared with T1,MAP of two groups and HR of group P were significantly increased on T2 and T3（P〈0.05）.HR of group P were significantly slower than that of group S on T1（P〈0.05）.The time of falling asleep and awakening up in two groups was similar.The MMSE scores on 30 min after operation of group P were lower than those of pre-anesthesia in group S,and the difference was significant（P〈0.05）.The incidence of respiratory depression,heart rate lower and body movement were significantly lower than those in group P（P〈0.05）.Conclusion Sevoflurane in the procedure of transrectal ultrasound-guided prostate biopsy,achieves good sedation and resultant hemodynamics with less interference with early recovery of postoperative cognitive function in patients.

关 键 词：七氟醚 丙泊酚 前列腺穿刺活检 认知功能 血流动力学 

分 类 号：R614.24[医药卫生—麻醉学]