依托咪酯和丙泊酚在老年颅脑手术麻醉诱导中的疗效分析

Efficacy analysis of etomidate and propofol in anesthesia induction of craniocerebral surgery in the elderly

目的探究老年颅脑手术麻醉诱导中应用依托咪酯和丙泊酚的疗效。方法68例接受颅脑手术的老年患者,随机分为常规组及实践组,每组34例。常规组实施依托咪酯与七氟烷联合麻醉,实践组实施依托咪酯与丙泊酚联合麻醉。比较两组患者术前、术中及术后2 h的灰质血流量、心率、血氧饱和度、收缩压、舒张压、平均动脉压。结果术前、术中与术后2 h,两组患者灰质血流量对比,差异无统计学意义(P>0.05)。术前及术后2 h,两组患者的心率对比差异无统计学意义(P>0.05);两组患者术中的心率均低于本组术前,术后2 h的心率均高于本组术中,差异有统计学意义(P<0.05);术中,实践组的心率(71.20±1.84)次/min高于常规组的(64.20±2.27)次/min,差异有统计学意义(P<0.05)。术前、术中和术后2 h,两组患者组内及组间的血氧饱和度对比,差异均无统计学意义(P>0.05)。组内:两组患者术中收缩压、舒张压均低于术前,术后2 h收缩压、舒张压均高于术中,差异具有统计学意义(P<0.05);实践组术中与术前平均动脉压对比,差异无统计学意义(P>0.05);常规组术中平均动脉压高于术前,差异具有统计学意义(P<0.05)。组间:术前及术后2 h,两组患者收缩压、舒张压、平均动脉压对比,差异无统计学意义(P>0.05);术中,实践组收缩压、舒张压高于常规组,平均动脉压低于常规组,差异具有统计学意义(P<0.05)。结论依托咪酯和丙泊酚应用在老年颅脑手术麻醉诱导中成效均为良好,安全性比较显著,能够使得患者多项指标趋于平稳化,值得使用与推广。

Objective To investigate the efficacy of etomidate and propofol in anesthesia induction of craniocerebral surgery in the elderly.Methods A total of 68 elderly patients undergoing craniocerebral surgery were randomly divided into conventional group and practice group,with 34 cases in each group.The conventional group received etomidate and sevoflurane combined anesthesia,and the practice group received etomidate and propofol combined anesthesia.The gray matter blood flow,heart rate,oxygen saturation,systolic blood pressure,diastolic blood pressure,and mean arterial pressure were compared between the two groups before surgery,during surgery and 2 h after surgery.Results Before surgery,during surgery and 2 h after surgery,there was no statistically significant difference in gray matter blood flow between the two groups(P>0.05).Before surgery and 2 h after surgery,there was no statistically significant difference in heart rate between the two groups(P>0.05).The heart rate during surgery of the two groups was lower than that of the group before surgery,and the heart rate 2 h after the surgery was higher than that of the group during surgery.All the difference was statistically significant(P<0.05).During surgery,the heart rate of the practice group was(71.20±1.84)beats/min,which was higher than(64.20±2.27)beats/min of the conventional group,and the difference was statistically significant(P<0.05).Before surgery,during surgery and 2 h after surgery,there was no statistically significant difference in blood oxygen saturation within and between the two groups(P>0.05).Within the group:the systolic blood pressure and diastolic blood pressure of the two groups during surgery were lower than those before surgery,and the systolic blood pressure and diastolic blood pressures 2 h after surgery were higher than those during surgery.All the difference was statistically significant(P<0.05).In the practice group,there was no statistically significant difference in mean arterial pressure during surgery and before surgery(P>0.05).The mean arterial pressure during surgery in the conventional group was higher than that before surgery,and the difference was statistically significant(P<0.05).Between groups:before srugery and 2 h after surgery,there was no statistically significant difference in systolic blood pressure,diastolic blood pressure,and mean arterial pressure between the two groups(P>0.05);during surgery,the systolic blood pressure and diastolic blood pressures of the practice group were higher than those of the conventional group,and the mean arterial pressure was lower than that of the conventional group.All the difference was statistically significant(P<0.05).Conclusion Combination of etomidate and propofol has a good effect in anesthesia induction of craniocerebral surgery in the elderly,and it is relatively safe.It can stabilize the indicators of patients and is worthy of application and promotion.