咪达唑仑丙泊酚全麻诱导对老年患者心率和血压的影响

Effect of midazolam and propofol on heart rate and blood pressure in gerontal patients during general anesthesia induction

目的：评估联合应用咪达唑仑与丙泊酚全麻诱导对老年患者心率和血压影响。方法：随机选取45例60岁以上ASAⅠ~Ⅱ级行择期外科手术患者分组：Ⅰ组为丙泊酚2.0 mg/kg诱导,Ⅱ组为咪达唑仑0.2 mg/kg诱导,Ⅲ组为丙泊酚1.0 mg/kg联合咪达唑仑0.1 mg/kg诱导,肌松剂均用维库溴胺0.1 mg/kg。采用完全随机双盲设计,记录诱导前后、插管时及插管后的心率和血压的变化,并比较记录结果。结果：三组患者术前心率和血压差异无显著性。插管前后Ⅰ组诱导引起心率变化与Ⅱ组和Ⅲ组比较差异有显著性。插管前后Ⅰ组诱导引起血压变化与Ⅱ组和Ⅲ组比较差异有显著性。结论：联合应用丙泊酚和咪达唑仑诱导,不仅能降低诱导时各自药量,而且对老年患者,特别是对于循环功能耐受较差者更为安全可靠。

Objective：To evaluate the effect of midazolam and propofol on the heart rate and blood pressure in gerontal patients during the general anesthesia induction.Methods：The completely randomized and double blindly design was taken.45 cases aged more than 60 years old with the physical state stage of ASA Ⅰ or Ⅱ for selective operations were divided into three groups.In group Ⅰ,the induction drug was propofol 2 mg/kg,in group Ⅱ,midazolam 0.2 mg/kg,in group Ⅲ,propofol 1 mg/kg,plus midazolam,0.1 mg/kg.The muscular relax was vecuronium with the dosage of 0.1 mg/kg.The changes of heart rate and blood pressure were recorded and analyzed before and after induction,also intubation.Results：The heart rate and blood pressure before induction among groups showed no differences.The changes of heart rate in group Ⅰ around induction showed statistically significant difference compared with that of group Ⅱ and Ⅲ.The changes of blood pressure in group Ⅰ around induction also showed statistically significant difference compared with that of group Ⅱ and Ⅲ.Conclusion：Combining propofol and midazolam for induction can improve the safety of the general anesthesia induction for gerontal patients,especially for those whose circulation compensation ability is poor.