七氟醚与丙泊酚用于老年手术患者全身麻醉诱导的效果比较

Comparison of the Effects of Sevoflurane and Propofol on General Anesthesia Induction in Elderly Operation Patients

目的:观察七氟醚与丙泊酚用于老年手术患者全身麻醉诱导的效果。方法:选择2010年12月-2012年12月收治的行全身麻醉外科手术的80例老年患者,采用完全随机化法均分为丙泊酚静脉诱导组(P组)和七氟醚吸入诱导组(S组),分别应用丙泊酚与七氟醚静脉麻醉。观察两组患者插管前后不同时间点血流动力学的变化及插管时间、意识消失时间,以及诱导插管时的不良反应情况。结果:两组患者插管时间相近(P>0.05),但S组患者意识消失时间显著短于P组,差异有统计学意义(P<0.01)。插管前(T1)及插管后10 min(T5)时两组患者收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)均显著低于诱导前(T0),差异有统计学意义(P<0.01);P组在T1时SBP、DBP、MAP、HR下降幅度大于S组,差异有统计学意义(P<0.05);在T1时,两组患者血氧饱和度[pbt(O2)]均较T0时显著上升,差异有统计学意义(P<0.05)。两组患者插管后1、3、5 min(T2、T3、T4)时SBP、DBP、MAP、HR较T1时均显著上升,差异有统计学意义(P<0.05)。P组患者出现体动、呼吸暂停、注射后静脉痛的例数显著高于S组患者,差异有统计学意义(P<0.01);S组患者出现呛咳、屏气的例数显著高于P组,差异有统计学意义(P<0.05),两组患者均未见其他不良反应发生。结论:七氟醚与丙泊酚均能对老年患者实施快速麻醉诱导,能引起血流动力学不同程度的变化,但七氟醚的麻醉诱导时间相对较短,对老年患者的循环、呼吸功能影响较小,诱导更为平稳,临床使用安全。

OBJECTIVE：To observe the effect of general anesthesia induction of sevoflurane and propofol of elderly operation patients.METHODS：80 elderly patients underwent general anesthesia in our hospital from Dec.2010 to Dec.2012 were randomly divided into propofol intravenous induction group（group P）and sevoflurane inhalation induction group（group S）.Sevoflurane and propofol were used for total intravenous anesthesia.The hemodynamic changes,intubation time,the time of consciousness disappearance and adverse reaction induced by intubation were observed in two groups before and after intubation at different time points.RESULTS：The intubation time of 2 groups was similar（P0.05）;But the time of consciousness disappearance in group S was significantly shorter in group P,there was statistical significance（P0.01）.SBP,DBP,MAP and HR of 2 groups at T1 and T5 were significantly lower than at T0;there was statistical significance（P0.01）,and the decrease of SBP,DBP,MAP and HR in group P were greater than in group S at T1;there was statistical significance（P0.05）.pbt（O2）of 2 groups was significantly increased at T1,compared with at T0;there was statistical significance（P0.05）.Compared with at T1,SBP,DBP,MAP and HR of 2 groups at T2,T3 and T4 were increased significantly,there was statistical significance（P0.05）.Case number of body movement,apnea and intravenous injection pain in group P were significantly higher in group S,there was statistical significance（P 0.01）.Case number of bucking and breathholding in group S were significantly higher than in group P,there was statistical significance（P0.05）;no other ADR was found in 2 groups.CONCLUSIONS：Sevoflurane and propofol can implement rapid induction of anesthesia for elderly patients,and can cause the changes of hemodynamics in different degree.Anesthesia induction time of sevoflurane is relatively short and had littler impact on circulation and respiratory function in elderly patients.Sevoflurane induce anesthesia more smoothly and is safe in the clinic.