【摘要】 目的探讨在丙泊酚联合瑞芬太尼应用的基础上,吸入地氟醚对老年患者的苏醒质量和不良反应的影响。方法选取全麻下行腹腔镜直肠癌根治术的老年患者82例。患者随机分为对照组(42例)和试验组(40例)。P组(对照组)术中使用丙泊酚和瑞芬太尼靶控输注进行麻醉维持;D组(试验组)靶控输注瑞芬太尼并同时吸入1MAC地氟醚,根据麻醉深度泵注丙泊酚。结果 D组(试验组)丙泊酚的用量、苏醒时间、拔管时间以及Aldrete评分≥9分的时间均小于单纯丙泊酚联合瑞芬太尼的患者(对照组),差异有统计学意义(P<0.05)。D组患者躁动评分为3分及以上的有6例,占D组人数15%,P组3分及以上的5例,占P组人数11.9%。两组间躁动评分无显著性差异(P>0.05)。苏醒期监测到的两组患者心动过速、恶心呕吐和呼吸抑制等不良反应发生率差异均无统计学意义(P>0.05)。结论静吸复合麻醉与全凭静脉麻醉相比,可提高老年患者的苏醒质量,针对老年人可达到理想的麻醉效果。更多还原

【Abstract】 Objective Explore the effect of wake quality and adverse reactions of using an anesthetic desflurane that is quickly eluded,on the basis of combined use of propofol combined fentanyl to quality in elderly patients.Methods 82 cases of elderly patients with total anesthesia were selected.Patients were randomized to two different group,42 in the control group and 40 in the experimental group.In P group(control group),propofol and remifentanil were used to maintain anesthesia.D group(test group)target controlled infusion of propofol,remifentanil and combined inhaled difluoroether.Results In D group(experimental group),the dosage of propofol,time of wake up,extubation time and the time of Aldrete score is greater than or equal to 9 minutes are less than pure propofol combined fentanyl patients(control group),the difference was statistically significant(P<0.05).In group D,there were 6 patients with a restlessness score of 3 and above,accounting for 15% of group D,and 5 cases of group P 3 and above,accounting for 11.9% of group P.There was no significant difference between the two groups(P>0.05).There was no statistically significant difference in the incidence of tachycardia,nausea,vomiting and respiratory depression between the two groups detected in the wake period(P>0.05).Conclusion The target controlled infusion of propofol,remifentanil and combined inhalation of desflurane can improve the resuscitation quality of the patients,and the ideal anesthetic effect can be achieved for the elderly.更多还原