阿片类药物对老年患者心脏系统的影响

Effects of Opioids on Cardiac System in Elderly Patients

随着全球期望寿命延长和医疗水平的提高,更多的老年患者拥有进行手术的机会,围术期并发症的发生风险较高,以并发心血管系统疾病多见,麻醉风险也随之增高。老年患者各器官系统储备功能低下,围术期间疼痛及外部刺激(如术中操作、气管插管等)容易引起内环境失衡,继而给老年患者预后带来了极大的安全隐患,其中维持心血管系统动态平衡尤为重要。临床常用镇痛药物以阿片类药物为主,维持血流动力学稳定的同时,兼具抗心律失常、保留或促进心脏机械功能恢复及心肌保护等积极作用,减少心血管不良事件的发生,使用前景开阔,在老年患者围术期安全方面具有重要价值。现就近些年来阿片类药物对老年患者心脏系统影响的研究进展情况进行系统阐述和归纳。

With the extension of global life expectancy and the improvement of medical level, more and more elderly patients have the opportunity to undergo surgery, and the risk of perioperative complica-tions is higher, especially cardiovascular diseases, and the risk of anesthesia is also increased. The organ system reserve function of elderly patients is low, and perioperative pain and external stim-ulation (such as intraoperative operation, endotracheal intubation, etc.) are easy to cause internal environment imbalance, which brings great safety risks to the prognosis of elderly patients. Among them, it is particularly important to maintain the dynamic balance of cardiovascular system. Opioids are mainly used in clinical analgesics, which not only maintain hemodynamic stability, but also play a positive role in anti-arrhythmia, preserving or promoting the recovery of cardiac mechanical function and myocardial protection, so as to reduce the occurrence of cardiovascular adverse events. The prospect of use is broad, which has important value in the perioperative safety of elderly patients. This paper systematically expounds and summarizes the research progress of the effects of opioids on the cardiac system of elderly patients in recent years.