酮咯酸氨丁三醇复合丙泊酚靶控静脉麻醉与静吸复合麻醉应用于老年肺癌肺叶切除术的麻醉效果比较  

Compare the Anesthesia Effect between Using Sufentanil Combined with Target-Controlled Infusion of Propofol Method and Vein Combined with Inhalation Method in Lung Cancer Treatment of Pulmonary Lobectomy

作　　者：李婷 LI Ting(Anesthesiology Department,Affiliated Hospital,Weifang Medical College,Shandong Province,Shandong Weifang 261042,China)

机构地区：[1]山东潍坊医学院附属医院麻醉科,山东潍坊261042

出　　处：《临床医药文献电子杂志》2019年第89期11-13,共3页Electronic Journal of Clinical Medical Literature

摘　　要：目的比较酮咯酸氨丁三醇复合丙泊酚靶控静脉麻醉与静吸复合麻醉应用于老年肺癌肺叶切除术麻醉效果。方法选择肺癌行肺叶切除术患者50例,年龄56~69岁,ASAⅠ~Ⅱ级。随机分为酮咯酸氨丁三醇-丙泊酚靶控静脉输注组(TCI组,A组)和静吸复合全麻组(B组)各25例。记录麻醉前(T0)、插管后5 min(T1)、单肺通气后5 min(T2)、拔管时(T3)术后24 h(T4)桡动脉的有创动脉压(收缩压SBP和平均动脉压MAP)、心率HR;比较苏醒指标及不良反应。结果 (1)B组麻醉诱导时T1时间段的SBP、MAP明显低于A组(P<0.01),两组诱导时T1时间段HR比麻醉诱导前T0时间段均降低(P<0.05);B组在手术T2、拔管T3时间段SBP、MAP均高于A组(P<0.05)。(2)A组与B组比较拔管时间、BIS降低至60的时间明显缩短(P<0.01),A组镇静程度OAA/S评分低于B组(P<0.05)。(3)A组恶心、呕吐、躁动等发生率高于B组;认知功能障碍MMSE评分显示在拔管时T3时间段A组11例(44%)B组16例(64%)(P<0.05),在术后24 hT4时间段A组3例(12%)B组13例(52%)(P<0.01)。结论酮咯酸氨丁三醇复合丙泊酚靶控静脉麻醉与静吸复合麻醉相比,因其靶控输注更精确控制麻醉深度使患者血流动力学稳定、苏醒时间短且产生不良反应少,更适用用于老年肺癌肺叶切除术。Objective To compare the effects of ketorolac tromethamine combined with propofol combined with targeted intravenous anesthesia in lobectomy for senile lung cancer.Methods Select 50 patients who was was performed by lobectomy for lung cancer,aged 56 to 69,ASA Ⅰ~Ⅱ level.Randomly divided into sufentanil,too-c poisson phenolic target intravenous infusion group control (TCI group,group A) and still suck composite anesthesia group (group B) all 25 cases.Invasive arterial pressure (SBP and mean arterial pressure MAP) and heart rate HR of the radial artery were recorded before anesthesia (T0),5min after intubation (T1),5min after one-lung ventilation (T2),24h after extubation (T3) and 24h after operation (T4).The recovery indicators and adverse reactions were compared.Results (1) In group B,the SBP and MAP in T1 period were significantly lower than those in group A (P<0.01),and the HR in T1 period was lower in both groups than that in T0 period before anesthesia induction(P<0.05).SBP and MAP of group B were higher than those of group A at the time of T2 operation and T3 extubation (P<0.05).(2) Compared with group B,the extubation time and BIS reduction time to 60 were significantly shortened (P<0.01),and the sedation degree OAA/S score in group A was lower than that in group B (P<0.05).(3)The incidence of nausea,vomiting and agitation in group A was higher than that in group B.The MMSE score of cognitive impairment showed that 11 cases (44%) of A group at the time of extubation;16 cases (64 %) of B group at the time of extubation;and 3 cases (12%) of A group at the time of extubation;and 13 cases (52%) of B group at the time of extubation.Conclusions Ketorolac tromethamine combined with propofol combined with target-controlled intravenous anesthesia is more suitable for lobectomy of elderly patients with lung cancer because its target-controlled infusion is more accurate in controlling the depth of anesthesia,which leads to stable hemodynamics,short recovery time and fewer adverse reactions.

关 键 词：靶控输注 静吸复合麻醉 酮咯酸氨丁三醇 丙泊酚 

分 类 号：R614[医药卫生—麻醉学]