老年全麻患者在麻醉诱导中分次使用丙泊酚对双腔支气管插管时心率、动脉压、BIS的影响

Effects of multiple uses of propofol on the heart rate,mean arterial pressure and bispectral index during double lumen bronchial intubation in elderly patients under general anesthesia

目的探讨老年全麻患者在麻醉诱导中分次使用丙泊酚对双腔支气管插管时心率、动脉压、脑电双频指数(BIS)的影响。方法随机选取2022年6月至2023年6月接受全麻手术的老年患者60例,按照数字表法随机分为观察组和对照组,每组30例。对照组给予丙泊酚单次给药,观察组给予丙泊酚分次输注,比较2组的心率、平均动脉压、BIS、手术时间、苏醒时间、丙泊酚用量、不良反应发生情况。结果T1时,观察组的心率、动脉压小于对照组(P<0.05)。对照组的心率、平均动脉压大于同组T0时(P<0.05)。T0、T2时,2组心率、平均动脉压组间比较以及与同组T0时比较,差异均无统计学意义(P>0.05)。T1、T2时,2组的BIS均小于同组T0时(P<0.05),T0、T1、T2时,2组BIS组间比较,差异均无统计学意义(P>0.05)。观察组的苏醒时间小于对照组(P<0.05)。与对照组比较,观察组的手术时间、丙泊酚用量比较,差异无统计学意义(P>0.05);术后1 d,2组的MoCA评分均低于同组术前1 d(P<0.05)。术前1 d及术后1 d,与对照组比较,观察组MoCA评分差异无统计学意义(P>0.05)。与对照组比较,观察组的不良反应发生率差异无统计学意义(P>0.05)。结论在麻醉诱导期,老年全麻患者使用丙泊酚分次给药,血流动力学波动和麻醉深度得到明显改善,安全性好。

Objective To investigate the effects of multiple uses of propofol on the heart rate(HR),mean arterial pressure(MAP)and bispectral index(BIS)during double lumen bronchial intubation in elderly patients under general anesthesia.Methods A total of 60 elderly patients who received general anesthesia in our hospital from June 2022 to June 2023 were randomly selected.According to the numerical table method,patients were randomly assigned into the observation group(n=30)and control group(n=30).A single administration of propofol was performed in the control group,and multiple uses of propofol were given to patients in the observation group.HR,MAP,BIS,operation time,recovery time,propofol dosage and incidence of adverse reactions between the two groups were compared.Results At T1,HR and MAP of the observation group were significantly lower than those of the control group(P<0.05).HR and MAP at T1 in the control group were significantly higher than those at T0.At T0 and T2,there were no significant differences in HR and MAP between the two groups or compared with the same group at T0(P>0.05).At T1 and T2,BIS in both groups was significantly lower than that at T0(P<0.05).At T0,T1 and T2,there was no significant difference in BIS between groups(P>0.05).The recovery time of observation group was significantly less than that of control group(P<0.05).There were no significant differences in operation time and propofol dosage between groups(P>0.05).One day after surgery,the Montreal Cognitive Assessment(MoCA)scores in both groups were significantly lower than those one day before surgery(P<0.05).One day before and one day after surgery,there was no significant difference in the MoCA score between the observation group and the control group(P>0.05).No significant difference was detected in the incidence of adverse reactions between groups(P>0.05).Conclusion In the induction period of anesthesia,the hemodynamic fluctuation and anesthesia depth of the elderly patients under general anesthesia can be significantly improved by using propofol,and with good safety.