老年肿瘤患者靶控输注舒芬太尼和丙泊酚的临床观察

Clinical application of sufentanil and propofol by target-controlled influsion in the elderly patients

目的:评价靶控输注舒芬太尼和丙泊酚对老年肿瘤患者麻醉的临床效果。方法:胃癌及直肠癌根治术38例,ASAⅠ～Ⅱ级,分两组:Ⅰ组年龄≥65岁,麻醉诱导血浆靶控输注舒芬太尼1.5ng/ml和丙泊酚2μg/ml,麻醉维持丙泊酚2μg/ml,舒芬太尼0.25～0.5ng/ml;Ⅱ组年龄25～55岁,麻醉诱导血浆靶控输注舒芬太尼1.5ng/ml和丙泊酚3μg/ml,麻醉维持丙泊酚3μg/ml,舒芬太尼0.25～0.5ng/ml。记录基础值(T1)、插管时(T2)、插管后1min(T3)、探查时(T4)和拔管时(T5)5个时点的MAP和HR,统计舒芬太尼及丙泊酚的用量,观察停止泵入舒芬太尼至患者睁眼的时间。结果:T2两组的MAP比T1无显著差异(P>0.05),而HR有显著差异(P<0.05);T3两组的MAP和HR比T1有显著差异(P<0.05);T4和T5的血流动力学比较平稳,手术过程HR有所下降(P<0.05),但整个手术过程都比较稳定,睁眼的时间和舒芬太尼的用量两组无显著差异(P>0.05),丙泊酚的用量两组有显著差异(P<0.05)。结论:靶控输注舒芬太尼和丙泊酚对老年肿瘤患者的麻醉是安全而可行的。

Objective：To evaluate the clinical benefit of sufentanil and propofol by target-controlled influsion in the elderly patients.Methods：38 patients undergoing gastrectomy and rectal surgery ASA Ⅰ-Ⅱ were divided into two groups： in Group Ⅰ （aged≥65） sufentanil was administered by TCI at a target blood concertration of 1.5ng/ml and propofol was 2μg/ml during induction of anesthesia.Propofol was administered by TCI at a target blood concertration of 2μg/ml and sufentanil was 0.25~0.5ng/ml during maintenance of anesthesia;in Group Ⅱ （aged25-55） sufentanil was administered by TCI at a target blood concertration of 1.5ng/ml and propofol was 3 μg/ml during induction of anesthesia. Propofol was administered by TCI at a target blood concertration of 3μg/ml and sufentanil was 0.25-0.5ng/ml during maintenance of anesthesia. MAP and HR at the time of foundation（T1）,intubation（T2）,1 min after intubation（T3）,exploration（T4） and extubation（T5） were recorded. The time when the patients opened their eyes and the total amaunt of sufentanU and propofol were recorded.Results：There was no difference in MAP at T2 and T1 between tow groups,but HR showed difference. MAP and HR were different at 33 from those at T1; hemedynamics was stable at T3 and T4,and HR decreased during the operation. The time when the patients opened their eyes and the total amaunt of sufentanil showed no differences between Group Ⅰ and Group Ⅱ （P〉0.05）,but the total of propofol was different（P〈0.05）.Conclusion：Sufentanil and propofol by target-controlled influsion applied in the elderly patients is safety.