应用瑞马唑仑与丙泊酚行全身麻醉诱导对老年腹部手术患者血流动力学的影响对比  

Comparison of the effects of remifentanil and propofol for induction of general anesthesia on hemodynamics in elderly patients undergoing abdominal surgery

作　　者：靳珂 周江生 赵艳芳 Jin Ke;Zhou Jiangsheng;Zhao Yanfang;Publish(Department of Anesthesiology,Henan Rongjun Hospital,Xinxiang 453000,China)

机构地区：[1]河南省荣军医院麻醉科,新乡453000

出　　处：《中国实用医刊》2024年第18期32-36,共5页Chinese Journal of Practical Medicine

摘　　要：目的对比瑞马唑仑与丙泊酚全身麻醉诱导对老年腹部手术患者血流动力学的影响及安全性。方法回顾性抽取2021年1月至2023年10月河南省荣军医院收治的60例行全身麻醉老年腹部手术的患者作为研究对象,按随机数字表法分为瑞马唑仑组和丙泊酚组,每组30例。瑞马唑仑组采用瑞马唑仑全麻诱导方案,丙泊酚组采用丙泊酚全身麻醉诱导方案。记录两组从诱导到脑电双频指数(BIS)<60的时间、苏醒时间;统计比较两组全身麻醉诱导前(T0)、麻醉诱导后1 min(T1)、麻醉诱导后3 min(T2)、气管插管即刻(T3)时心率(HR)、平均动脉压(MAP)、大脑中动脉平均血流(Vm)、阻力指数(RI),并记录拔管后1、5 min时Riker镇静-躁动评分(SAS)及两组围术期不良事件。结果瑞马唑仑组诱导到BIS<60的时间、苏醒时间均短于丙泊酚组(P均<0.05)。两组MAP组间、时点、组间·时点比较,差异均有统计学意义(P均<0.05),而两组HR、Vm、RI组间、时点、组间·时点比较,差异未见统计学意义(P>0.05)。拔管后1 min,瑞马唑仑组SAS评分低于丙泊酚组(P<0.05);拔管后5 min,两组SAS评分比较差异未见统计学意义(P>0.05)。两组围术期不良事件发生率比较差异未见统计学意义(P>0.05)。结论丙泊酚与瑞马唑仑应用于老年腹部手术患者中的镇静效果及安全性相当,但瑞马唑仑在血液动力学稳定方面更具有优势。Objective To compare the effects and safety of remifentanil and propofol during induction of general anesthesia on hemodynamics in elderly patients undergoing abdominal surgery.Methods Sixty elderly patients who underwent abdominal surgery under general anesthesia in Henan Rongjun Hospital from January 2021 to October 2023 were selected retrospectively as the study subjects.According to the random number table method,the enrolled patients were divided into a remifentanil group and a propofol group,with 30 cases in each group.The remifentanil group received remifentanil for induction of general anesthesia,while the propofol group received propofol for induction of general anesthesia.The time from induction to bispectral index(BIS)<60 and awakening time in the two groups were recorded.The heart rate(HR),mean arterial pressure(MAP),mean cerebral artery blood flow(Vm),and resistance index(RI)at different time points,before general anesthesia induction(T0),1 minute after anesthesia induction(T1),3 minutes after anesthesia induction(T2)and immediately after tracheal intubation(T3),of the two groups were counted and compared.The Riker sedation agitation score(SAS)at 1 and 5 minutes after extubation,as well as the occurrence of perioperative adverse events,in both groups were recorded.Results The time from induction to BIS<60 and awakening time in the remifentanil group were shorter than those in the propofol group(all P<0.05).The differences in inter-group comparison,time-series comparison and time-series inter-group comparison of MAP were statistically significant(all P<0.05).There was no statistical significant difference in inter-group comparison,time-series comparison and time-series inter-group comparison of HR,Vm and RI(P>0.05).The SAS score of the remifentanil group was lower than that of the propofol group at 1 minute after extubation,with a statistical significant difference(P<0.05).There was no statistical significant difference in SAS scores between the two groups 5 minutes after extubation(P>0.05).There was

关 键 词：瑞马唑仑 丙泊酚 腹部手术 老年人 全身麻醉诱导 血流动力学 

分 类 号：R614[医药卫生—麻醉学]