小剂量芬太尼复合七氟烷在喉罩通气老年疝修补术患者中的应用效果

Application effect of small dose Fentanyl combined with Sevoflurane in laryngeal mask airway for elderly patients undergoing hernia repair

目的探讨小剂量芬太尼复合七氟烷在喉罩通气老年疝修补术患者中的应用效果。方法选取我院2015年2月~2016年8月在我院进行喉罩通气疝修补手术的76例老年患者作为研究对象,根据不同麻醉方式分为复合组和对照组,每组38例。复合组患者应用小剂量芬太尼复合七氟烷进行麻醉,对照组患者单用七氟烷进行麻醉。比较两组患者的心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO_2)、呼吸末二氧化碳分压(PETCO_2)的变化,并观察两组患者的麻醉诱导时间、苏醒时间及不良反应发生率。结果复合组患者的麻醉诱导时间、术后苏醒时间较对照组患者短,差异有统计学意义(P<0.05)。复合组患者麻醉后的HR、PETCO_2水平均低于对照组患者,MAP、SpO_2水平均高于对照组患者,差异有统计学意义(P<0.05)。复合组的不良反应发生率低于对照组(5.26%vs.23.68%),差异有统计学意义(P<0.05)。结论小剂量芬太尼复合七氟烷应用于喉罩通气疝修补术老年患者,能够使患者的术中麻醉程度和术后苏醒时间更便于控制,安全性更高、麻醉效果更好,且降低了不良发生率,值得推广应用。

Objective To investigate the application effect of small dose Fentanyl combined with Sevoflurane in laryngeal mask airway in elderly patients undergoing hernia repair.Methods From February 2015 to August 2016,76 elderly patients with laryngeal mask airway hernia repair were selected as the research object,and divided into the composite group and the control group according to different anesthesia methods,each group had 38 cases.The composite group re- ceived anesthesia with a small dose of Fentanyl combined with Sevoflurane.The control group received only Sevoflurane anesthesia.The level of heart rate （HR）,mean arterial pressure （MAP）,pulse oxygen saturation （SpO2）,Partial pressure of carbon dioxide at the end of respiration （PErCO2） changes were compared between the two groups,and anesthesia induc- tion time,recovery time and the incidence of adverse reaction were observed between the two groups.Results The anes- thesia induction time and postoperative recovery time of the composite group were shorter than those of the control group,and the difference was statistically significant （P〈O.05）.After anesthesia,the level of HR,PzrCO2 in the composite group were lower than those in the control group,and the level of MAP and SpO2 were higher than those in the control group,the difference was statistically significant （P〈0.05）.The incidence of adverse reactions in the composite group was lower than that in the control group （5.26% vs. 23.68%）,and the difference was statistically significant （P〈0.05）.Con- clusion A small dose of Fentanyl and Sevoflurane in laryngeal mask airway in elderly patients undergoing hernia repair can make the patient＇s intraoperative anesthesia and postoperative recovery time more convenient control,higher safety, better anesthetic effect,and reduce the incidence of adverse events,it is worth promoting and application.