术中静脉输注硫酸镁对老年高血压患者全麻苏醒期质量及血流动力学的影响
Effect of intraoperative intravenous magnesium sulfate infusion on quality and hemodynamics during gen-eral anesthesia awakening in elderly hypertensive patients
徐海 1刘莺歌 2张颖 3周洲 3桑小巧 3张小宝4
作者信息
- 1. 锦州医科大学,辽宁锦州 121001
- 2. 南京医科大学连云港临床医学院,江苏连云港 222000
- 3. 徐州医科大学附属连云港医院麻醉科,江苏连云港 222000
- 4. 徐州医科大学附属连云港医院麻醉科,江苏连云港 222000;南京医科大学康达学院第一附属医院麻醉科,江苏连云港 222000
- 折叠
摘要
目的:探讨术中静脉输注硫酸镁对老年高血压患者全麻苏醒期质量及血流动力学的影响.方法:选取择期行膝关节置换术且合并有高血压的老年患者60例,年龄60～85岁,美国麻醉医师协会分极Ⅱ或Ⅲ级.根据随机数字表法分为硫酸镁组(M组)和对照组(C组),每组30例.评价苏醒期Richmond躁动-镇静评分(RASS)、Ramsay镇静评分,并记录呛咳、躁动等不良反应的发生情况,记录两组患者入室时刻(T0)、诱导前(T1)、诱导后(T2)、插管后即刻(T3)、切皮时(T4)、手术开始15 min(T5)、30 min(T6)、45 min(T7)和拔管时(T8)的MAP、HR,记录术中全麻药物及血管活性药物用量以及患者自主呼吸恢复时间、睁眼时间和拔管时间.结果:与C组比较,M组RASS评分明显降低,患者躁动和呛咳事件发生率均显著降低(P＜0.05),T3、T8时MAP明显降低、HR显著减慢,T4时MAP明显降低(P＜0.05).两组患者术中丙泊酚用量差异无统计学意义,但M组患者瑞芬太尼的用量较C组明显减少(P＜0.05).M组患者自主呼吸恢复时间、睁眼时间和拔管时间较C组均明显延长,但呼吸恢复至拔管的时间明显缩短(P＜0.05).结论:术中静脉输注硫酸镁可为行膝关节置换术的老年高血压患者提供稳定的血流动力学,并改善患者的苏醒质量.
Abstract
OBJECTIVE To explore the effect of intraoperative intravenous magnesium sulfate infusion on quality and hemo-dynamics during general anesthesia awakening in elderly hypertensive patients.METHODS A total of 60 elderly hypertensive ASA Ⅱ/Ⅲ patients aged 60 to 85 years undergoing elective knee arthroplasty were selected.They were randomized into two groups of magnesium sulfate(M)and control(C)(n=30 each).During awakening period,Richmond Agitation-Sedation Score(RASS)and Ramsay Sedation Scale were evaluated.And the occurrences of choking and agitation were recorded.MAP and HR were measured at different timepoints of admission(T0),pre-induction(T1),post-induction(T2),immediate post-intubation(T3),skin incision(T4)and intra-operation at 15 min(T5),30 min(T6),45 min(T7)and extubation(T8)in both groups.Doses of general anesthesia and vasoactive drugs during operation,as well as time of recovery of spontaneous respiration,eye-opening and extubation,were also recorded.RESULTS As compared with group C,group M had a notably lower RASS score and lower incidences of agitation and choking(P＜0.05);At T3/T8,Group M had significantly lower levels of mean arterial pressure(MAP)and heart rate(HR).Additionally,group M had significantly lower MAP at T4(P＜0.05).Although intraoperative dose of propofol did not differ significantly between groups,dose of remifentanil was considerably lower in group M(P＜0.05).Group M had longer recovery for spontaneous respiration,eye-opening and extubation.However,interval between recovery of spontaneous respiration and extubation was notably shorter in group M(P＜0.05).CONCLUSION An intraoperative intrave-nous infusion of magnesium sulfate may provide stable hemodynamics and improve the quality of awakening for elderly hyperten-sive patients undergoing knee arthroplasty.
关键词
硫酸镁/老年/高血压/苏醒质量/躁动Key words
magnesium sulfate/elderly/hypertension/quality of awakening/agitation引用本文复制引用
基金项目
江苏省六大人才高峰项目(WSW-329)
连云港市第一人民医院临床研究基金项目(LC13)
出版年
2024
NETL
NSTL
万方数据