依托咪酯联合丙泊酚靶控输注全麻对老年手术患者血流动力学及肾上腺皮质功能的影响

Effects of Etomidate Combined with Propofol Target Controlled Infusion General Anesthesia on Hemodynamics and Adrenocortical Function in Elderly Surgical Patients

目的观察依托咪酯和丙泊酚联合靶控输注全麻对老年手术患者血流动力学及肾上腺皮质功能的影响。方法选择2018年3月-2020年3月毕节市第一人民医院收治的88例行全身麻醉的老年手术患者的临床资料进行回顾性分析,将其中采取的依托咪酯联合丙泊酚靶控输注全麻的患者设为观察组(n=44),给予丙泊酚靶控输注全麻的患者设为对照组(n=44)。评估2组麻醉前和麻醉结束10 min后患者血流动力学与肾上腺皮质功能,同时统计2组不良反应,观察苏醒与拔管时间,对2组上述指标值进行比较和分析。结果观察组MAP、HR和SVR均明显低于对照组(P<0.05)。观察组Cor以及醛固酮均明显低于对照组(P<0.05)。观察组不良反应发生率明显低于对照组(11.36%vs 31.82%,P<0.05)。观察组苏醒时间和拔管时间均显著短于对照组(P<0.05)。结论老年患者采用依托咪酯联合丙泊酚靶控输注全麻的应用效果明显,患者血流动力学稳定,肾上腺皮质功能得到改善,具有一定的临床应用价值。

Objective To observe the effects of etomidate combined with propofol target controlled infusion general anesthesia on hemodynamics and adrenocortical function in elderly surgical patient.Methods The clinical data of 88 elderly patients undergoing general anesthesia in our hospital from March 2018 to March 2020 were retrospectively analyzed.The patients who received etomidate combined with propofol target controlled infusion general anesthesia were set as the observation group(n=44),and the patients who received propofol target controlled infusion general anesthesia were set as the control group(n=44).Hemodynamics and adrenocortical function were evaluated before and 10 minutes after anesthesia in two groups;The adverse reactions of the two groups were counted and the time of recovery and extubation were observed.The above index values were compared between both groups.Results The MAP and HR in the control group were higher than those in the observation group(P<0.05).The levels of Cor and aldosterone were higher in the control group than those in the observation group(P<0.05).The incidence of adverse reactions in the control group was higher than that in the observation group(31.82%vs 11.36%,P<0.05).The recovery time and extubation time of the observation group were significantly shorter than those of the control group(P<0.05).Conclusion Etomidate combined with propofol target-controlled infusion for general anesthesia has obvious application effects in elderly surgical patient,which can stabilize hemodynamics,improve adrenocortical function and has certain clinical application value.