不同麻醉策略对衰弱老年胃癌患者麻醉效果的影响

Influence on anaesthesia effect of different anesthetic strategies in senile patients with gastric cancer

目的探讨不同麻醉策略对衰弱老年胃癌患者麻醉效果的影响。方法选取年龄≥65岁择期行胃癌根治手术的衰弱患者70例,按照麻醉策略分为对照组(全身麻醉,40例)和观察组(超声引导下腹横肌平面阻滞复合全身麻醉,30例)。记录患者的一般临床资料;记录不同时刻2组患者的平均动脉压(MAP)和心率(HR),记录术中舒芬太尼的用药量、住院总费用以及术后恢复等临床资料。结果与对照组相比,观察组患者在切皮时和手术结束时MAP和HR的值下降,且围术期舒芬太尼用药量降低,有统计学差异(P<0.05);观察组患者的总花费降低,术后苏醒时间缩短,差异有统计学意义(P<0.05)。结论采用超声引导下腹横肌平面阻滞复合全身麻醉可以稳定老年衰弱胃癌患者的血压和心率,减少阿片类药物的用量,缩短麻醉苏醒时间,加快术后恢复,改善术后转归。

Objective To explore the anesthetic effects of different anesthesia strategy on frail elderly patients undergoing gastric cancer surgery.Methods Seventy frail patients aged≥65 years were randomly divided into a control group(general anesthesia,n=40)and an observation group[(ultra-sound-guided transversus abdominis plane block,Tapb-block combined general anesthesia,n=30)].Mean arterial pressure(MAP)and heart rate(HR)at different times,the amount of sufentanil used during the operation and the general clinical data such as total hospitalization cost and postoperative recovery of the two groups were recorded.Results Compared with the control group,MAP and HR values,as well as the perioperative sufentanil dosage in observation group were decreased significantly at the time of skin cutting and the end of operation(P<0.05).The total cost of observation group decreased,and the postoperative recovery time was shortened significantly,too(P<0.05).Conclusion Tap-block combined general anesthesia can stabilize blood pressure and heart rate,reduce the dosage of opioids,shorten the time of anesthesia recovery,speed up postoperative recovery and improve postoperative outcomes in elderly patients with gastric cancer.