依托咪酯和异丙酚用于老年患者麻醉诱导的效果比较

Comparison of the effects between etomidate and propofol during induction of general anesthesia in elderly patients

目的探讨依托咪酯和异丙酚用于老年人外科手术全麻诱导血液动力学的变化。方法择期全麻腹部手术的老年患者80例,ASAⅡ～Ⅲ级,随机分为依托咪酯组(E组,40例)和异丙酚组(P组,40例)。诱导期,两组分别给予依托咪酯和异丙酚,同时给予相同的咪唑安定﹑芬太尼﹑维库溴铵。结果 E组麻醉起效时间较P组慢(P<0.05);诱导后P组的BP和HR下降更明显(P<0.05),插管后回升至正常范围,差异也有统计学意义(P<0.05);E组BP和HR变化无显著意义(P>0.05)。结论依托咪酯能保持循环功能相对稳定,更适于老年患者全麻诱导。

Objective To discuss the cardiovasvular response during induction of general anesthesia in elderly patients, surgery with etomidate and propofol. Methods All of 80 ASA Ⅱ～Ⅲ elderly patients undergoing abdominal surgery under general anesthesia were randomly divided into etomidategroup and propofol group with 40 cases in each. Two groups respectively administrated etomidate and propofol during induction period. At the same time, midazolam, fentanyl, vecuroni um were administrated. Results E group was slower than P group in anesthesia response time （P 〈 0.05 ）; BP and HR markedly reduced after induction in group P（P 〈 0.05 ）, and increased to normal range after tracheal intubation, the difference was significant（P 〈 0.05）; the little change of BP and HR in group P was not significant（P 〉 0.05）. Conclusion Etomidate can keep the circulatory function more stable, which is more suitable for the induction of general anesthesia in elderly patients.