论文部分内容阅读
目的观察麻醉诱导后预注麻黄碱在老年患者无痛胃镜检查中的应用效果。方法将150例老年患者(年龄≥60岁),ASA分级Ⅰ～Ⅱ级,随机均分为A、B、C三组。三组诱导前静脉注射利多卡因0.08 mg/kg,以丙泊酚2 mg/kg和麻黄碱80μg/kg混合液行麻醉诱导。A组患者在麻醉诱导前1 min先静脉注射芬太尼1μg/kg,C组在诱导后2 min单次预注麻黄碱70μg/kg,患者入睡、睫毛反射消失后开始胃镜检查。观察三组患者麻醉诱导前(T1)、麻醉诱导后2 min(T2)、麻醉诱导后5 min(T3)、麻醉诱导后10 min(T4)的收缩压(SBP)、舒张压(DBP),心率(HR),血氧饱和度(SpO2),各组患者麻醉效果、苏醒质量和苏醒时间及呛咳、呕吐、呼吸抑制、低血压、心动过缓等不良反应。结果 A、B两组T2、T3时刻SBP、DBP和HR较基础值(T1)显著降低,差异有统计学意义(P<0.05),而C组SBP、DBP和HR在各时间点比较差异无统计学意义(P>0.05),组间比较T4时刻差异无统计学意义(P>0.05)。C组低血压、心动过缓和呼吸抑制发生率分别为2%、2%、0,明显低于A组的26%、8%及8%,B组的20%、6%、2%。与A、B两组比较,C组苏醒时间平均缩短1.6 min,苏醒质量优于A、B两组。各组麻醉效果比较差异无统计学意义(P>0.05)。结论老年患者无痛胃镜检查中应用丙泊酚与麻黄碱混合液诱导后预注麻黄碱可显著减轻对循环及呼吸系统的抑制程度,血流动力学稳定,同时能缩短苏醒时间,提高苏醒质量,减少不良反应的发生率,麻醉安全性高。
Objective To observe the effect of pre-injection of ephedrine after induction of anesthesia in painless gastroscopy in elderly patients. Methods 150 elderly patients (≥60 years old) and ASA grade Ⅰ ~ Ⅱ were randomly divided into A, B and C groups. Three groups before induction of intravenous lidocaine 0.08 mg / kg, with propofol 2 mg / kg and ephedrine 80 μg / kg anesthesia induction. Patients in group A received intravenous injection of fentanyl 1 μg / kg 1 min prior to induction of anesthesia, and group C received a single pre-injection of ephedrine 70 μg / kg 2 min after induction. Patients fell asleep and eyelash reflex disappeared and gastroscopy was started. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the three groups before anesthesia induction (T1), 2 min after induction of anesthesia (T2), 5 min after induction of anesthesia (T3) Heart rate (HR), oxygen saturation (SpO2), anesthesia effect, awakening quality, recovery time and adverse reactions such as cough, vomiting, respiratory depression, hypotension and bradycardia in each group. Results The SBP, DBP and HR at T2 and T3 were significantly lower than those at baseline (T1) in groups A and B (P <0.05), while the differences of SBP, DBP and HR in group C were not significant at all time points Statistical significance (P> 0.05), there was no significant difference between two groups (P> 0.05). The incidences of hypotension, bradycardia and respiratory depression in group C were 2%, 2% and 0, respectively, which were significantly lower than those of 26%, 8% and 8% in group A and 20%, 6% and 2% in group B, respectively. Compared with group A and group B, the recovery time of group C was shortened 1.6 min on average, and the awakening quality was better than group A and group B. There was no significant difference in the anesthetic effects among all groups (P> 0.05). Conclusions The induction of ephedrine by propofol and ephedrine mixture in painless gastroscopy in elderly patients can significantly reduce the degree of inhibition of circulation and respiratory system, stabilize hemodynamics, shorten the recovery time and improve wakefulness , Reduce the incidence of adverse reactions, high anesthesia safety.