老年手术麻醉应用依托咪酯的效果观察

Observation on the Effect of Etomidate in Elderly Surgical Anesthesia

目的探讨老年手术中采用依托咪酯麻醉的临床效果。方法选取我院2014年1月至2016年1月期间接诊的138例老年手术患者,随机分为观察组和对照组各69例。两组均给予镇痛药联合肌松药,在此基础上,观察组给予依托咪酯麻醉,对照组给予丙泊酚麻醉。对比两组的镇痛效果,并观察各项临床指标。结果观察组的术后睁眼时间、自主呼吸恢复时间、拔管时间和定向力恢复所需时间均显著短于对照组,差异具有统计学意义(P<0.05)。观察组的下地时间、进食时间和住院时间均显著短于对照组,差异具有统计学意义(P<0.05)。观察组的术后肺动脉压、心率、中心静脉压显著优于对照组(P<0.05)。结论老年患者全麻诱导中使用依托咪酯,血流动力学平稳,尤其是对有心脑血管疾病老年人有较高安全性,值得临床推广应用。

Objective To explore the clinical effect of etomidate in elderly surgical anesthesia. Methods 138 cases of elderly surgicalpatients admitted to our hospital from January 2014 to January 2016 were selected and randomly divided into observation group and controlgroup, with 69 cases in each group. Patients of both two groups received analgesics combined with muscle relaxants. On this basis, theobservation group received etomidate for anesthesia, while the control group received propofol for anesthesia. The analgesic effects werecompared between two groups, and the clinical indicators were observed. Results The postoperative time of operming eyes, recovery time ofspontaneous breathing, extubation time and recovery time of directional ability of observation group were significantly shorter than those ofcontrol group, with statistical differences （P 〈0.05）. The ambulation time, eating time and hospitalization time of observation group weresignificantly shorter than those of control group, with statistical differences （P〈0.05）. The postoperative pulmonary artery pressure, heart rateand central venous pressure of observation group were significantly better than those of control group （P〈0.05）. Conclusions The use ofetomidate in the induction of general anesthesia in the elderly patients has stable hemodynamics and high safety, especially for elderlypatients with heart cerebrovascular disease, which is worthy of clinical promotion and application.