普鲁卡因静脉复合麻醉对老年病人心脏电生理的影响

Effects of Intravenous Procaine Balanced Anesthesia on Cardiac Electrophysiology in Old Patients

目的：研究静脉普鲁卡因复合麻醉（ＩＰＢＡ）对老年病人心电生理的影响。方法：采用经食道心房起搏法，观察１４例老年择期手术病人ＩＰＢＡ后有关心电生理参数的变化。结果：ＩＰＢＡ后，ＳＡＣＴ显著缩短，ＳＲ间期显著延长（均为Ｐ＜００５）；ＱＴｃ显著延长（Ｐ＜００１），ＱＴｃ＞０４５的发生率显著增高（Ｐ＝０００９）；余６项心电生理参数均无显著变化（Ｐ＞００５）。结论：ＩＰＢＡ可较安全地用于无心电生理障碍的老年病人，但应加强术中心电监测。

Objective and Methods:The cardiac electrophysiologic changes of 14 old patients receiving intravenous procaine balanced anesthesia (IPBA) for selective surgery were studied by transesophageal pacing. Results: After IPBA, no significant changes were observed in 6 cardiac electrophysiological parameters( P> 0 05).But SACT was significantly shortened ( P< 0 05),SR duration was significantly lenthened( P< 0 05), QTc was signigicantly lengthened ( P< 0 01) and the incidence of QTc>0 45 was significantly increased( P <0 01). Conclusion: IPBA can be safely used in old patients without cardiac electrophysiologic disorders but attention must be paied to monitoring ECG, including QTc. Care showld be taken when IPBA is used in old cases with certain AV conductive block or long QTc.