七氟醚与依托咪酯麻醉诱导对老年腹部手术患者应激反应及血液流变学的影响  

The impact of sevoflurane and etomidate for elderly patients with abdominal surgery on stress response and hemorheology

作　　者：李国艳[1] 侯明勇[1] 李佳[1] LI Guo-yan;HOU Ming-yong;LI Jia(Department of Anesthesiology,Chengdu Municipal First People's Hospital,Chengdu 610041,China)

机构地区：[1]成都市第一人民医院麻醉科,四川成都610041

出　　处：《实用医院临床杂志》2020年第5期171-174,共4页Practical Journal of Clinical Medicine

摘　　要：目的比较七氟醚、依托咪酯麻醉诱导对老年腹部手术患者应激反应及血流动力学的影响。方法选择2018年8月至2019年7月择期腹部手术老年患者85例,随机数字表法分为七氟醚组44例、依托咪酯组41例。七氟醚组采用咪达唑仑、舒芬太尼、七氟醚、顺式苯磺酸阿曲库铵麻醉诱导,依托咪酯组采用咪达唑仑、舒芬太尼、依托咪酯脂肪乳、顺式苯磺酸阿曲库铵麻醉诱导。比较麻醉诱导前(T0)、插管1 min(T1)、插管3 min(T2)、插管5 min(T3)、插管10 min(T4)两组应激反应、血流动力学、不良反应。结果T1~T4时,七氟醚组皮质醇(Cor)、血糖(Glu)低于依托咪酯组(P<0.05);T1时,七氟醚组收缩压(SBP)、舒张压(DBP)高于依托咪酯组,心率(HR)低于依托咪酯组,T2~T4时,七氟醚组SBP、DBP、HR均低于依托咪酯组(P<0.05);两组恶心呕吐等不良反应比较,差异无统计学意义(P>0.05)。结论七氟醚诱导麻醉有助于缓解老年腹部手术患者插管应激反应,维持血流动力学的相对稳定。Objective To investigate the effect of sevoflurane and etomidate for elderly patients with abdominal surgery on stress response and hemorheology.Methods Eighty-five elderly patients with abdominal surgery from August 2018 to July 2019 were divided into sevoflurane group(n=44)and etomidate group(n=41).The sevoflurane group was given midazolam,sufentanil,sevoflurane,and cisatracurium besilate for anesthesia induction while the etomidate group was given midazolam,sufentanil,etomidate,and cisatracurium besilate for anesthesia induction.The stress response,hemodynamics and adverse reaction before anesthesia induction(T0),at intubation 1 min(T1),intubation 3 min(T2),intubation 5 min(T3)and intubation 10 min(T4)were compared between the two groups.Results The serum cortisol and blood glucose from T1 to T4 in the sevoflurane group were lower than those in the etomidate group(P<0.05).At T1,systolic blood pressure(SBP)and diastolic blood pressure(DBP)were higher while heart rate(HR)was lower in the sevoflurane group than those in the etomidate group.At T2 toT4,SBP,DBP and HR in the sevoflurane group were lower than those in the etomidate group(P<0.05).There was no significant difference in adverse reactions between the two group(P>0.05).Conclusion Compared with etomidate,sevoflurane induced anesthesia can alleviate the stress response,and maintain the relative stability of hemodynamics.

关 键 词：老年 腹部手术 七氟醚 依托咪酯 应激反应 血流动力学 

分 类 号：R614.2[医药卫生—麻醉学]