摘要
目的 探讨异丙酚复合瑞芬太尼应用于老年高血压患者手术麻醉中的临床效果.方法 126 例老年高血压患者,随机分为研究组和对照组,每组 63 例.对照组予以异丙酚麻醉维持,研究组在对照组的基础上复合瑞芬太尼进行麻醉维持.比较两组患者麻醉效果(异丙酚用量、意识消失时间、苏醒时间、不良反应发生情况、定向力恢复时间);治疗前后的视觉模拟评分法(VAS)评分、镇静评分标准(Ramsay)评分;不同时间血流动力学指标[心率(HR)、平均动脉压(MAP)、收缩压(SBP)及舒张压(DBP)].结果 研究组丙泊酚用量(88.26±23.37)mg少于对照组的(109.08±23.74)mg,意识消失时间(30.26±9.37)s、苏醒时间(287.51±18.93)s、定向力恢复时间(341.17±10.97)s均短于对照组的(37.08±10.74)、(335.65±19.28)、(441.45±15.84)s,不良反应发生率 3.2%低于对照组的 12.7%(P<0.05).麻醉后,研究组患者VAS评分(1.22±0.13)分低于对照组的(3.11±0.12)分,Ramsay评分(4.21±0.45)分高于对照组的(2.37±0.54)分(P＜0.05).气管插管之后即刻(T1)、手术开始即刻(T2)、结束手术时(T3)时,研究组的HR、MAP、SBP、DBP均低于对照组(P＜0.05).结论 异丙酚复合瑞芬太尼应用于老年高血压患者手术中的麻醉效果更加显著,镇痛时间更长,可以缓解患者术后应激反应,降低不良反应发生率,改善患者血流动力学水平,使患者尽快苏醒,值得推广.
Abstract
Objective To explore the clinical effect of propofol combined with remifentanil in anesthesia in elderly patients with hypertension.Methods 126 elderly hypertensive patients were randomly divided into the study group and the control group,with 63 cases in each group.The control group was anesthetised with propofol,and the study group was anesthetised with propofol combined with remifentanil.Patients in both group were compared in terms of anesthetic effects(propofol dosage,time to loss of consciousness,recovery time,occurrence of adverse reactions,recovery time of orientation),visual analogue scale(VAS)score and Ramsay score before and after treatment,hemodynamic parameters[heart rate(HR),mean arterial pressure(MAP),systolic blood pressure(SBP)and diastolic blood pressure(DBP)]at different time points.Results The propofol dosage of(88.26±23.37)mg in the study group was lower than(109.08±23.74)mg in the control group;in the study group,the time to loss of consciousness was(30.26±9.37)s,the recovery time was(287.51±18.93)s,and the recovery time of orientation was(341.17±10.97)s,which were shorter than(37.08±10.74),(335.65±19.28)and(441.45±15.84)s in the control group;the incidence of adverse reactions of 3.2%in the study group was lower than 12.7%in the control group(P<0.05).After anesthesia,VAS score of(1.22±0.13)points in the study group was lower than(3.11±0.12)points in the control group,and Ramsay score of(4.21±0.45)points was higher than(2.37±0.54)points in the control group(P<0.05).Immediately after intubation(T1),immediately at the beginning of surgery(T2),and at the end of surgery(T3),HR,MAP,SBP,DBP of the study group were lower than those of the control group(P<0.05).Conclusion The application of propofol combined with remifentanil in elderly patients with hypertension has more significant anesthetic effect and longer analgesia time,which can reduce the postoperative stress reaction and adverse reaction probability of patients,improve the hemodynamic level and make patients wake up as soon as possible,which is worthy of promotion.
维普
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