异丙酚复合瑞芬太尼在老年高血压患者手术中的麻醉效果分析  

Analysis of anesthetic effect of propofol combined with remifentanil in elderly hypertensive patients undergoing surgery

作　　者：王健 姜义 李显才 WANG Jian;JIANG Yi;LI Xian-cai(Department of Anesthesiology,Fuxin Mining General Hospital of Liaoning Health Industry Group,Fuxin 123000,China)

机构地区：[1]辽宁省健康产业集团阜新市矿总医院麻醉科,123000

出　　处：《中国实用医药》2024年第1期100-103,共4页China Practical Medicine

摘　　要：目的观察异丙酚复合瑞芬太尼在老年高血压患者手术中的麻醉效果。方法108例老年高血压患者,按电脑随机双盲分组方式分为复合组和对照组,各54例。对照组患者手术中使用单一异丙酚进行麻醉维持,复合组患者手术中使用异丙酚复合瑞芬太尼进行麻醉维持。对比两组患者各时间点血压、心率、血流动力学指标[动脉血氧分压(PaO_(2))和二氧化碳分压(PaCO_(2))]及警觉/镇静观察评分、拔管时间、恢复室停留时间、不良反应发生情况。结果复合组患者术中的心率、舒张压、收缩压分别为(72.26±8.29)次/min、(106.61±2.12)mm Hg(1 mm Hg=0.133 kPa)、(155.67±3.98)mm Hg,拔管后分别为(70.10±8.15)次/min、(103.36±2.10)mm Hg、(153.39±4.04)mm Hg;对照组患者术中的心率、舒张压、收缩压分别为(78.41±8.56)次/min、(112.64±2.55)mm Hg、(163.37±3.82)mm Hg,拔管后分别为(75.64±8.43)次/min、(107.23±2.41)mm Hg、(159.18±3.93)mm Hg;复合组患者术中及拔管后的心率、舒张压、收缩压均显著低于对照组,经统计学比较具显著差异(P<0.05)。术中和拔管后,复合组的PaO_(2)、PaCO_(2)分别为(12.06±1.08)、(6.37±0.51)kPa和(12.32±0.84)、(5.63±0.40)kPa,对照组的PaO_(2)、PaCO_(2)分别为(11.33±1.52)、(8.04±0.98)kPa和(11.95±0.57)、(6.02±0.65)kPa;术中和拔管后,复合组的PaO_(2)相比对照组更高,PaCO_(2)相比对照组更低,经统计学比较后具有显著差异(P<0.05)。复合组患者警觉/镇静观察评分(4.79±0.31)分明显高于对照组的(3.05±0.22)分,拔管时间(13.39±2.18)min和恢复室停留时间(40.34±10.19)min明显短于对照组的(20.46±2.79)、(58.42±12.06)min,经统计学比较后具有显著差异(P<0.05)。复合组患者的不良反应发生率为5.56%,明显低于对照组不良反应发生率的18.52%,经统计学比较后具显著差异(P<0.05)。结论异丙酚复合瑞芬太尼在老年高血压患者手术麻醉中的效果十分理想,具极佳的推广�Objective To observe the anesthetic effect of propofol combined with remifentanil in elderly hypertensive patients undergoing surgery.Methods 108 elderly patients with hypertension were divided into a compound group and a control group by computer randomized double-blind grouping,with 54 cases in each group.In the control group,propofol alone was used for anesthesia maintenance,while in the compound group,propofol combined with remifentanil was used for anesthesia maintenance.Comparison was made on blood pressure,heart rate,hemodynamic indexes[arterial oxygen partial pressure(PaO_(2))and carbon dioxide partial pressure(PaCO_(2))]at each time point,alertness/sedation score,extubation time,recovery room residence time and adverse reactions between the two groups.Results In the compound group,the intraoperative heart rate,diastolic blood pressure and systolic blood pressure were(72.26±8.29)beats/min,(106.61±2.12)mm Hg(1 mm Hg=0.133 kPa)and(155.67±3.98)mm Hg;after extubation,they were(70.10±8.15)beats/min,(103.36±2.10)mm Hg and(153.39±4.04)mm Hg,respectively.In the control group,the intraoperative heart rate,diastolic blood pressure and systolic blood pressure were(78.41±8.56)beats/min,(112.64±2.55)mm Hg and(163.37±3.82)mm Hg;after extubation,they were(75.64±8.43)beats/min,(107.23±2.41)mm Hg and(159.18±3.93)mm Hg,respectively.The heart rate,diastolic blood pressure and systolic blood pressure of the compound group were significantly lower than those of the control group during surgery and after extubation,with statistically significant differences(P<0.05).During surgery and after extubation,PaO_(2) and PaCO_(2) in the compound group were(12.06±1.08),(6.37±0.51)kPa and(12.32±0.84),(5.63±0.40)kPa,respectively;in the control group,PaO_(2) and PaCO_(2) were(11.33±1.52),(8.04±0.98)kPa and(11.95±0.57),(6.02±0.65)kPa,respectively.After surgery and after extubation,the compound group had higher PaO_(2) than the control group and lower PaCO_(2) than the control group,and the difference was statistically si

关 键 词：老年高血压 手术麻醉 异丙酚 瑞芬太尼 

分 类 号：R614[医药卫生—麻醉学]