快通道麻醉在ASAⅡ～Ⅲ级老年患者麻醉中的应用

Past-way anesthesia in senile patients with ASAⅡ～Ⅲ

目的探讨瑞芬太尼联合丙泊酚双通道靶控输注全凭静脉麻醉与静吸复合全麻在ASAⅡ～Ⅲ级老年患者全身麻醉中的应用。方法择期手术50例,年龄62～89岁,ASAⅡ～Ⅲ级,手术时间1～3h。随机分为2组,瑞芬太尼-丙泊酚靶控输注组(TCI组)和静吸复合全麻组(I组),每组25例。分别采用全凭静脉和静吸复合维持麻醉,观察术毕停药后患者自主呼吸恢复的时间、睁眼时间、拔管时间、离开手术间的时间,并观察术后是否有恶心、呕吐、呼吸抑制、术后躁动、肌肉僵直等不良反应。结果TCI组患者较I组术毕停药后自主呼吸恢复的时间、睁眼时间、拔管时间、离开手术间的时间均早,并且术后不良反应低。结论与静吸复合全麻相比,在ASAⅡ～Ⅲ级老年患者全身麻醉中应用瑞芬太尼联合丙泊酚双通道靶控输注全凭静脉麻醉,患者血流动力学更平稳,术后苏醒快,不良反应少,麻醉效果及安全性好,值得推广。

Objective To observe the clinical effect of remifentanil and propofol target-controlled infusion （TCI） or infusion and inhalation for general anesthesia in senile patients with ASAⅡ～Ⅲ.Methods 50 patients aged 60～89 with ASA Ⅱ～Ⅲ undergrowing electric surgery were randomly divided into 2 groups.Target-controlled infusion group （TCI group） and infusion-inhalation group（I group）,25 cases in each group.The time of surgery was from 1 hour to 3 hours.The TCI group was given remifentanil combined with propofol for the induced anesthesia and maintenance anesthesia.The I group was given fentanil combined with propofol for the induced anesthesia and was given propofol combined with influence for the maintenance anesthesia.We recorded the time of recovery of spontaneously breathing and consciousness,the time of opening eyes,extubation time and the time of leaving operating room after surgery.We also recorded the adverse reaction after surgery.Results The time of recovery of spontaneously breathing and consciousness,the time of opening eyes,extubation time and the time of leaving operating room after surgery in TCI group was shorter than I group （P0.05）.Conclusion When senile patients with ASAⅡ～ Ⅲ are given general anesthesia remifentanil and propofol target-controlled infusion are reliable and effective methods.This shoud be recommended.