不同靶浓度瑞芬太尼在老年患者胸科手术麻醉中的临床观察

Clinical value of different target concentrations of remifentanil in elderly patients with thoracic surgery anesthesia

目的探讨不同靶浓度瑞芬太尼应用于老年患者胸外科手术麻醉的价值。方法选择2010年12月—2013年12月胸外科接受择期手术治疗的90例患者按照随机数字法分为A、B、C三组,每组30例,手术进行麻醉诱导时三组应用瑞芬太尼靶浓度依次为4、6、8μg/L,比较三组各时间段MAP、SBP及HR、手术情况等。结果 A组在T2、T4以及T5时的血压水平及HR水平均升高明显,B组和C组的心率及血压升高抑制效果好,C组T1时MAP、SBP及HR均明显降低;A组在T2时EN及E水平均明显升高,B、C组明显低于A组;T3时三组的HR、血压、NE以及E水平均较T0时明显升高。结论在老年胸科手术麻醉中应用6μg/L瑞芬太尼联合异丙酚靶控输注可有效减轻患手术应激反应,提高手术安全性,值得推广应用。

Objective To investigate the value of different target concentrations of remifentanil in elderly patients with thoracic surgery anesthesia. Methods Totally 90 patients undergoing thoracic surgery in our hospital between January 2011 and December 2013 were collected. The patients were randomly divided into A, B, C three groups, 30 cases of each group, when the three groups were applied induction of anesthesia remifentanil concentrations were 4μg / L, 6μg / L, 8μg/L. The MAP, SBP and HR, the operation of plasma norepinephrine and epinephrine of the 3 groups were compared. Results At T2, T4 and T5 ,the blood pressure levels and HR of group A were significantly increased, while in group B and group C, the heart rate and blood pressure is good inhibitory effect, T1 when the MAP, SBP and HR were significantly lower in group C ; A group were significantly higher at T2 and E EN water, B, C group was significantly lower than that in group A; T3 when the three groups of HR, BP, NE and E levels were significantly higher than those at T0. Conclusion 6μg / L remifentanil propofol in elderly anesthesia with thoracic surgery can effectively reduce the risk of surgical stress response, ensure safe operation, should be widely applied.