不同麻醉方案在老年多发肠息肉患者中的应用效果对比

发布时间：2018-04-25 00:26

本文选题：右美托咪定 + 肠镜　；参考：《中国老年学杂志》2017年20期

【摘要】：目的分析不同麻醉方案在多发肠息肉老年患者中的应用效果。方法择期行肠镜下多发肠息肉摘除术的72例老年患者随机分为观察组和对照组各36例。观察组、对照组术中分别给予小剂量右美托咪定(DEX)联合舒芬太尼、丙泊酚联合舒芬太尼的麻醉方案,根据术中情况加用丙泊酚、麻黄碱、阿托品等。比较给药前(T1)、置入肠镜时(T2)、手术开始15 min(T3)、退镜时(T4)、离开手术室(T5)的心率(HR)、呼吸频率(RR)、平均动脉压(MAP)、血氧饱和度(SpO_2)、脑电双频指数(BIS)值及手术时间、苏醒时间、术后恢复室(PACU)的停留时间、术中麻黄碱、阿托品、丙泊酚的应用量、不良反应。结果与T1相比,观察组各时间点的HR、RR、MAP、SpO_2均未出现明显变化(P0.05),仅T2、T3、T4的BIS值显著降低(P0.05);对照组T2、T3、T4的RR、MAP、SpO_2、BIS值均显著降低(P0.05),T5的MAP显著升高(P0.05)。两组T1的HR、RR、MAP、SpO_2、BIS值差异无统计学意义(P0.05)。观察组T2、T3、T4的RR、MAP、SpO_2、BIS值均显著高于对照组(P0.05)。两组手术时间差异无统计学意义(P0.05)。观察组苏醒时间、PACU的停留时间均显著低于对照组(P0.05)。两组均未应用阿托品,观察组术中未应用麻黄碱,显著低于对照组(P0.05)。观察组术中丙泊酚用量显著低于对照组(P0.05)。观察组无低血压、呼吸抑制、头晕,2例术中明显体动和1例消化道不适。观察组低血压、呼吸抑制发生率显著低于对照组(P0.05)。结论对行无痛肠镜下多发息肉摘除术的老年患者而言,小剂量DEX联合舒芬太尼对呼吸、循环的影响轻微,且镇静深度较低,患者可随时被叫醒并配合操作,清醒镇静效果令人满意。
[Abstract]:Objective to analyze the effect of different anesthetic schemes in elderly patients with multiple intestinal polyps. Methods Seventy-two elderly patients undergoing selective endoscopic polyp resection were randomly divided into observation group (n = 36) and control group (n = 36). In the observation group, the control group was given low dose dexmetomidine (DEX) combined with sufentanil, propofol and sufentanil respectively, and propofol, ephedrine and atropine were added according to the intraoperative conditions. The heart rate (HRP), respiratory frequency (RRV), mean arterial pressure (MAPP), oxygen saturation (SPO _ 2), bispectral index (BISs), recovery time, recovery time and recovery time were compared. The duration of postoperative recovery of PACUC, the amount of ephedrine, atropine, propofol, adverse reactions. Results compared with T1, there was no significant change in HR-RRP-MAPSpO2 at all time points in the observation group, but the BIS value of T2 + T3 + T4 was significantly lower than that of the control group (P _ (0.05)), while the MAP of the control group (T _ (2) T _ (3) T _ (4)) was significantly lower than that of the control group (P _ (0.05) P _ (0.05)). There was no significant difference in BIS between the two groups (P 0.05). In the observation group, the values of RRX MAPS-SpO2BIS were significantly higher than those of the control group (P 0.05). There was no significant difference in operation time between the two groups (P 0.05). The recovery time of PACU in the observation group was significantly lower than that in the control group (P 0.05). No atropine was used in both groups, and ephedrine was not used in the observation group, which was significantly lower than that in the control group (P 0.05). The dosage of propofol in the observation group was significantly lower than that in the control group (P 0.05). There was no hypotension, respiratory inhibition, obvious body movement in 2 cases and digestive tract discomfort in 1 case in the observation group. The incidence of hypotension and respiratory depression in the observation group was significantly lower than that in the control group (P 0.05). Conclusion for the elderly patients undergoing painless multiple polyposis resection, the effects of low dose DEX combined with sufentanil on respiration and circulation are slight, and the depth of sedation is low, patients can be woken up and cooperate with the operation at any time. The sober sedation effect is satisfactory.
【作者单位】：济南市第三人民医院手术室麻醉科;
【分类号】：R614

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