靶控瑞芬太尼复合七氟醚在老年人全麻诱导中的应用

The Application of TCI Remifentanil with Sevoflurane on Induction of General Anesthesia of Old Patients

目的探讨靶控输注瑞芬太尼复合七氟醚用于老年人全麻诱导的可行性并寻找最佳靶浓度。方法择期全麻手术老年患者（63~75岁）40例,按瑞芬太尼血浆靶浓度随机分为4组：（R2、R3、R4、R5组）,即2、3、4、5ng/ml组,七氟醚吸入浓度为3%,与瑞芬太尼同时开始诱导,脑电双频指数（BIS）达60时静注罗库溴铵辅助插管。分别记录患者诱导前（T0）、BIS达60时（T1）、插管前即刻（T2）、插管后1分钟（T3）、插管后3分钟（T4）的SBP、HR。结果 R2组插管后1分钟及3分钟的SBP高于插管前;R3组插管前后SBP差别不显著;R4、R5组有循环抑制。结论靶控瑞芬太尼复合七氟醚能安全应用于老年人全麻诱导,瑞芬太尼3ng/ml复合3%七氟醚诱导能较好地控制气管插管时的血流动力学变化。

Objective To inquire into the best target plasma concentration when TCI remifentanil with sevoflurane is applying on induction of general anesthesiaof old patients.MethodsForty elective surgery under general anesthesia aged patients（aged from 63 to 75）were randomly divided into four groups（n=10） with a different remifentanil target plasmargery.Sevoflurane was started at 3%.Trachea was intubated following intravenous rocuronium when the BIS of patients was 60.Note the SBP and HR of T0（before the induction）,T1（when the BIS comes to 60）,T2（right before cannula）,T3（one minute after cannula） and T4（three minutes after cannula）.ResultsBoth of the SBP of group R2 which has been intubated for one and three minutes are higher than before（P0.05）,and there is no difference with significance of the SBP of group R3 before and after cannula.There is circulation restraint between R4 and R5.Conclusions TCI remifentanil with sevoflurane can be safely applied on induction of general anesthesia of aged patients,the hemodynamics response can be well controlled by the induction of remifentanil（3ng/ml） and sevoflurane（3%）.