地氟烷与七氟烷用于老年患者麻醉的效果比较

Comparison of Therapeutic Efficacy of Desflurane and Sevoflurane for Anesthesia of Elderly Patients

目的:比较地氟烷和七氟烷用于老年患者麻醉中的有效性与安全性。方法:采用随机、平行对照的方法,将120例拟行麻醉的老年患者按计算机随机序列分为试验组和对照组,各60例。在常规用药及处理的基础上,对照组患者采用七氟烷吸入麻醉,试验组患者采用地氟烷吸入麻醉。于麻醉前,插管后2、10 min,手术开始后2、30 min以及手术完成时记录患者的血压、心率;同时记录患者的术后拔管时间、睁眼时间、意识恢复时间以及术后并发症。结果:试验组患者在插管后10 min时的心率明显较对照组快,差异有统计学意义(P<0.05),在其他时间点,两组患者的血压、心率比较差异均无统计学意义(P>0.05);试验组患者的术后拔管时间和意识恢复时间较对照组明显缩短,差异有统计学意义(P<0.05);术后并发症主要表现为低血压、高血压、支气管痉挛、恶心呕吐和烦躁不安,试验组和对照组患者术后并发症发生率分别为25.0%和40.0%,差异有统计学意义(P<0.05)。结论:地氟烷用于老年患者外科手术麻醉的效果较好、术后并发症较少。

OBJECTIVE： To compare therapeutic efficacy and safety of desflurane and sevoflurane for anesthesia of elderly pa- tients. METHODS： A randomized, parallel-controlled method was used, 120 elderly patients undergoing anesthesia were random- ized into trial group and control group, with 60 cases in each group. Based on routine medication and disposal, control group was additionally given sevoflurane for anesthesia, and trial group given desflurane for anesthesia. The blood pressure and heart rate were recorded before anesthesia, 2 rain and 10 min after intubation, 2 min and 30 rain after the start of the operation; the extubation time, eye opening time, consciousness recovery time and postoperative complications were also recorded. RESULTS： 10 rain after intubation, the heart rate of trial group was significantly faster then that of control group, with statistical significance （P〈0.05） ; the blood pressure and heart rate of 2 groups had no statistically significant difference between 2 groups at other time points （P〉 0.05）. The extubation time and consciousness recovery time of trial group were significantly shorter than those of control group, with statistical significance （P〈0.05）. The postoperative complications mainly were hypopiesia, hypertension, bronchospasm, nau- sea and vomiting, and dysphoria; the incidence of postoperative complications in trial group and control group were 25.0% and 40.0%, with statistical significance （P〈0.05）.