【摘要】 目的探讨丙泊酚联合瑞芬太尼在老年高血压患者手术麻醉中的效果。方法随机选择近年来ASA分级Ⅰ~Ⅲ级,择期老年高血压患者胆囊切除手术60例,分为两组,每组30例。对照组为D组,维持麻醉单纯用丙泊酚,观察组为G组,用丙泊酚复合瑞芬来维持麻醉。比较病人两组SBp、DBp、HR变化、麻醉药物的使用情况,PACU苏醒情况和并发症。结果两组HR,SBp、DBp变化之趋势相同,两组各个时间点HR,SBp、DBp相比较,均没有显著性差异(P>0.05)。观察组(G组),PACU拔管时间显著大于对照组(D组)(P<0.05),患者OAA/S评分,显著大于对照组(D组)(P<0.05),硝酸甘油与艾司洛尔的静脉用量均明显小于对照组(D组)(P<0.05),PACU停留时间,差异没有显著性(P>0.05)。观察组(G组)不良反应之发生率为6.6%(2/30),对照组为26.1%(8/30),两者差异明显有统计学的意义(P<0.05)。结论瑞芬太尼联合丙泊酚应用于老年高血压患者的手术,其术中麻醉的血流动力学指标,波动更小,苏醒质量更佳,更少的并发症,值得我们进一步推广使用。更多还原

【Abstract】 Objective To investigate the effect of propofol combined with remifentanil in elderly patients with hypertension.Methods Randomly selected ASA class Ⅰ ~ Ⅲ in recent years,the quiet elderly hypertensive patients with 60 cases of gallbladder surgery,divided into two groups,30 cases in each group. Compared with group D,maintained anesthesia with propofol alone,the observation group as the group G,to maintain anesthesia with propofol compound ray Stevens. Compare two groups of patients with SBP. DBP,HR changes,and the usage of narcotic drugs,to revive the PACU,and complications. Results Two groups of HR,SBP,DBP change trend of the same,two groups of various points in HR,SBP,DBP,were not significant difference( P > 0. 05).Observation group( group G),and PACU decannulation time was significantly greater than the control group( group D)( P<0.05),the patient OAA/S score,significantly greater than the control group( group D)( P<0.05),nitroglycerin and Yi Si Luo intravenous dosage were significantly less than the control group( group D)( P<0.05),the PACU,residence time,was not significant difference( P > 0. 05). Observation group( group G)incidence of adverse reactions was 6. 6%( 2 / 30),the control group was 26. 1%( 8 / 30),the difference was statistically significant( P< 0. 05). Conclusions Remifentanil combined with propofol in elderly patients with hypertension surgery,for hemodynamic indexes of anesthesia during operation,has less volatile,better quality,less complication,which is worthy of further promotion.更多还原