丙泊酚靶控输注全身麻醉维持在老年胃癌根治术中的应用

Application of Propofol Target Controlled Infusion for General Anesthesia in Elderly Patients with Gastric Cancer Undergoing Radical Gastrectomy

目的分析丙泊酚靶控输注全身麻醉维持在老年胃癌根治术中的应用价值。方法研究对象选取本院2012年8月~2015年7月收治的82例老年胃癌根治术患者,随机将患者分为甲组和乙组各41例。甲组患者应用丙泊酚靶控输注全身麻醉维持、乙组患者采取七氟烷吸入。记录两组患者麻醉前、切片后5 min、手术30 min、手术第60 min、停药即刻以及出手术室时的血流动力学指标变化;同时对比两组患者的睁眼时间、拔管时间等指标。结果甲乙两组患者麻醉开始后心率、血压指标发生明显的下降,对比麻醉前的差异显著,手术第60 min的各项指标开始回升,对比甲组和乙组各个时间点的指标差异小,无统计学意义（P〉0.05）;甲组患者的拔管时间与定向力恢复时间短于乙组,对比差异结果具有统计学意义（P〈0.05）。结论丙泊酚靶控输注全身麻醉维持对患者的血流动力学影响小,且术后苏醒时间短,在老年胃癌根治手术中具有很高的价值。

Objective To analyze the application value of propofol target controlled infusion in the maintenance of general anesthesia in elderly patients with gastric cancer undergoing radical gastrectomy.Methods A total of 82 elderly patients with gastric cancer undergoing radical gastrectomy in Shenyang Weikang Hospital from August 2012 to July2015 were selected as the research subjects.These patients were randomly divided into group A and group B,41 cases in each group.Patients in the group A were treated with target controlled infusion of propofol for general anesthesia maintenance and the group B were treated with seven sevoflurane.hemodynamic changes of patients in the two groups were recorded before anesthesia,at 5min after section,at 30 min and 60 min of the operation,drug-stopping instantly and out of the operating room; at the same time,patients＇ eyes time,drawing tube time and other indicators were compared between the two groups.Results After beginning of anesthesia,heart rate,blood pressure index in the group A and the group B occurred significantly decreased,compared with before anesthesia,the difference was significant.When surgery was carried out to 60 min,the indicators began to pick up.The small difference in the indicators between the group A and the group B at each time point,no statistical significance（P〉0.05）; The extubation time and directional force recovery time in the group A were shorter than that of the group B,the difference was statistically significant（P〈0.05）.Conclusions Target controlled infusion of propofol for general anesthesia maintenance has little effect on the hemodynamics of the elderly patients with gastric cancer,and recovery time of postoperation is short,it is of high value in the radical operation of gastric cancer in elderly patients.