两种麻醉方式对老年患者术后恢复期循环呼吸及神经系统的影响

Effects of two different anesthesia methods on circulation,respiratory and nervous system of elderly patients during postoperative recovery period

目的观察两种麻醉方式对老年手术患者术后麻醉恢复期循环、呼吸及神经系统的影响,探讨老年患者更适宜的麻醉方式。方法选取该院2011年1月-2013年12月90例接受手术的老年患者,比较接受全身麻醉与全身麻醉复合硬膜外麻醉术后恢复期患者循环、呼吸及神经参数的变化。结果两组患者拔管后呼吸频率(RR)增快,每分通气量(MV)和血氧饱和度(SPO2)降低。复合组患者气管插管后平均动血压(MAP)和心率(HR)相对稳定,与全麻组比较差异有统计学意义。两组患者出现吞咽反射时间、拔管时间、完全清醒时间及术后1、2和3 d的简易精神状态检查表(MMSE)评分比较,差异有统计学意义(P<0.05)。结论全身麻醉复合硬膜外麻醉能很好地维持循环、呼吸及神经系统功能,是更适合于老年患者的麻醉方式。

[Objective] To observe the effects of two anesthesia methods on circulation, respiratory and nervous systems of elderly patients during postoperative recovery period, and to explore the suitable anesthesia method for elderly patients. [Methods] Ninety elderly patients, who accepted operation in our hospital from Jan. 2011 to Dec. 2013, were enrolled into the study. The differences in circulatory, respiratory and neural parameters in postoperative period were compared between the elderly patients receiving general anesthesia （general anesthesia group） and those accepting general anesthesia combined with epidural anesthesia （composite group）. [Results] RR increased but MV and SPO2 decreased when the two groups of patients were extubated. MAP and HR were relatively stable in the composite group after tracheal intubation, there were significant differences compared with those in the general anesthesia group. Swallowing reflex time, extubation time, awakening time and postoperative 1-, 2- and 3-d mini-mental state examination （MMSE） scores of the patients were significantly different between the two groups （P〈 0.05）. [Conclusions] The general anesthesia combined with epidural anesthesia can help to maintain stable hemodynamics, respiratory and never functions, which may be suitable for elderly patients.