不同靶浓度瑞芬太尼在老年患者胸科手术麻醉中的临床分析

发布时间：2018-08-01 17:44

【摘要】：目的探究不同靶浓度的瑞芬太尼在老年胸科手术患者麻醉中的应用价值,为临床提供参考。方法 87例老年胸科手术患者,根据给予瑞芬太尼浓度的不同分为4、6、8μg/L组,每组29例,对比分析三组患者麻醉时间、意识丧失时间、恢复自主呼吸时间、睁眼时间、拔管时间及不同时间段[T0(进入手术室后平卧10 min)、T1(麻醉诱导后)、T2(插管时)、T3(插管后3 min)、T4(手术切皮后)、T5(开胸探查时)、T6(手术结束)、T7(拔管)]平均动脉压(MAP)、收缩压(SBP)、心率(HR)水平。结果三组麻醉时间、意识丧失时间、恢复自主呼吸时间、睁眼时间、拔管时间比较差异无统计学意义(P0.05)。4μg/L组在T2、T4、T5时间点的SBP、MAP、HR水平高于T0时间点,而6μg/L组和8μg/L组SBP、MAP、HR水平相对较好;8μg/L组在T1时间点的SBP、MAP、HR水平较T0时降低较为显著;6μg/L组的SBP、MAP、HR水平较其他两组较为良好。结论在老年患者的胸科手术中,使用6μg/L浓度的瑞芬太尼进行诱导麻醉可有效减轻患者在手术过程中的应激反应,增加患者手术的安全性,值得推广。
[Abstract]:Objective to explore the application value of remifentanil with different target concentrations in elderly patients undergoing thoracic surgery. Methods Eighty-seven elderly patients undergoing thoracic surgery were divided into 4 groups with 6 渭 g / L remifentanil and 29 patients in each group. The time of anesthesia, loss of consciousness, recovery of spontaneous respiration and time of eye opening were compared and analyzed in three groups. The time of extubation and the mean arterial pressure (MAP),) (SBP), (HR) level in T _ 0 (supine 10 min) T _ 1 (after anesthesia induction) T _ 2 (3 min after intubation) T _ 4 (after incision) and T _ 5 (after thoracotomy) T _ 6 (after operation) and T _ 7 (extubation)]. Results there was no significant difference in anesthesia time, consciousness loss time, recovery time of spontaneous respiration, time of opening eyes and time of extubation in the three groups (P0.05). The SBPnMAPHR level in the 6 渭 g / L group and 8 渭 g / L group was better than that in the 8 渭 g / L group at T1 time. The SBPnMAPHR level in the 6 渭 g / L group was significantly lower than that in the T0 group, and that in the 6 渭 g / L group was better than that in the other two groups. Conclusion Induction anesthesia with 6 渭 g / L remifentanil during thoracic surgery in elderly patients can effectively reduce the stress response and increase the safety of the patients. It is worth popularizing.
【作者单位】：江苏省淮安市淮阴医院麻醉科;
【分类号】：R614

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