不同剂量瑞芬太尼复合丙泊酚对老年高血压腹部手术患者血流动力学及苏醒情况的影响  

Effects of different doses of remifentanil combined with propofol on hemodynamics and wakefulness in elderly patients with hypertension and abdominal surgery

作　　者：蒋会[1] 王兰兰[1] JIANG Hui;WANG Lanlan(Fujian Provincial Cancer Hospital,Fuzhou 350000,China)

机构地区：[1]福建省肿瘤医院,福州市350000

出　　处：《临床合理用药杂志》2020年第26期6-7,26,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察不同剂量瑞芬太尼复合丙泊酚对老年高血压腹部手术患者血流动力学及苏醒情况的影响。方法选取2018年2月-2019年5月福建省肿瘤医院收治的腹腔镜下老年高血压腹部手术患者90例为研究对象,根据麻醉方案不同分为A、B组,每组45例。A组术中予以瑞芬太尼3.0μg·kg-1·min-1复合丙泊酚维持麻醉,B组予以瑞芬太尼2.0μg·kg-1·min-1复合丙泊酚维持麻醉,比较2组术前(T0)、术毕(T1)、拔管时(T2)、拔管后10 min(T3)平均动脉压(MAP)、心率(HR),苏醒情况及不良反应。结果T0时,2组MAP、HR比较差异无统计学意义(P>0.05),B组T1、T2、T3时MAP、HR优于A组(P<0.05或P<0.01);B组患者呼吸恢复时间、气管导管拔除时间、苏醒时间均短于A组(P<0.01);B组不良反应发生率为4.4%,低于A组的17.8%(χ2=4.050,P=0.044)。结论瑞芬太尼2.0μg·kg-1·min-1复合丙泊酚用于老年高血压腹部手术中可保持患者血流动力学平稳,促使患者术后尽快苏醒,且安全性较高,值得临床推广应用。Objective To investigate the effects of different doses of remifentanil combined with propofol on hemodynamics and wakefulness in elderly patients with hypertension and abdominal surgery.Methods 90 elderly patients undergoing laparoscopic abdominal hypertension underwent laparoscopic treatment in Fujian Provincial Cancer Hospital from February2018 to May 2019 were selected as the research subjects,and were divided into 45 cases each in group A and group B according to different anesthesia protocols.In group A,remifentanil 3.0μg·kg-1·min-1 combined with propofol was used to maintain anesthesia;in group B,remifentanil 2.0μg·kg-1·min-1 combined with propofol was used to maintain anesthesia.Preoperative(T0),postoperative(T1),extubation(T2),and 10 min(T3)post-extubation mean arterial pressure(MAP),heart rate(HR),awake conditions,and adverse reactions rate to observe.Results There were no significant differences in MAP and HR at T0 between the two groups(P>0.05),and there were a significant difference in MAP and HR between the two groups at T1,T2,and T3(P<0.05 or P<0.01);The respiratory recovery time,tracheal tube removal time,and wake-up time were shorter in group B than in group A(P<0.01);The incidence of adverse reactions in group B was 4.44%,which was significantly lower than 17.78%in group A(χ2=4.050,P=0.044).Conclusion Remifentanil 2.0μg·kg-1·min-1 combined with propofol can maintain stable hemodynamics during abdominal surgery in elderly patients with hypertension and promote postoperative wake-up.

关 键 词：老年高血压 腹部手术 瑞芬太尼 不同剂量 丙泊酚 血流动力学 苏醒情况 

分 类 号：R614[医药卫生—麻醉学]