老年患者实施术中保温对其全麻BIS恢复及苏醒期丙泊酚效应室浓度的优化影响分析

Effect of heat preservation on the recovery of BIS and the concentration of propofol in the recovery of propofol in elderly patients

目的分析讨论术中保温对老年患者全麻BIS恢复时间及苏醒期丙泊酚效应室浓度的影响,以期为临床提供指导性依据。方法选取武警浙江省总队嘉兴医院收治的全麻下行开腹胃肠外科手术的老年患者78例为调查对象,患者年龄均为60岁以上,参照双盲随机法将患者划分为对照组与研究组,每组例数均为39。对照组仅予以液体输入与铺巾覆盖,研究组则采取液体输入、腹腔冲洗液体加温以及暖风毯覆盖等术中保温措施,记录比较2组患者从麻醉开始到手术完成不同时间点的食管温度与MAP,同时观察患者苏醒时间与效应室浓度等的差异。结果 2组患者在T_0、T_1的食管温度差异无统计学意义,研究组T_2~T_6的食管温度均明显高于对照组（P〈0.05）,另2组不同时间点的MAP均无明显差异;2组患者丙泊酚停药时BIS值无明显差异,而在停药时BIS≥80恢复时间及其效应室浓度则有明显差异（P〈0.05）。结论行全麻开腹手术治疗的老年患者实施术中保温有助于维持患者全麻下正常体温,缩短术后BIS恢复时间,降低苏醒期丙泊酚效应室浓度,加快患者术后苏醒,临床应用价值较高。

Objective To analyze and discuss the effect of heat preservation on the recovery time of BIS and the concentration of propofol in the recovery period of the elderly patients with general anesthesia in order to provide guidance for clinical treatment.Methods78 elderly patients with general anesthesia were selected as the subjects, and the patients were divided into the control group and the study group with 39 cases in each group.The patients were divided into the control group and the study group.Control group, only to be liquid input and covered by drapes, research group take liquid input and peritoneal flushing fluid heating and heating blanket coverage of insulation measures, were recorded and compared between the two groups from anesthesia began to operation to complete the different time points of esophageal temperature and MAP, and to observe the recovery time of patients and effect compartment concentration differences.ResultsTwo groups at T0, T1 esophageal temperature no significant difference, study group t2-t6 esophageal temperatures were significantly higher than those of the control group （P〈0.05）, maps of the other two groups at different time points had no significant difference;when two groups of patients with propofol withdrawal BIS values had no significant difference （P〈0.05）, and in the time of discontinuation BIS is more than or equal to 80 recovery time and effect compartment concentration have significant difference （P〈0.05）.ConclusionThe surgical treatment of elderly patients with general anesthesia can help maintain the body temperature, shorten the recovery time of BIS and reduce the concentration of propofol in the recovery period.