老年人腹腔镜胆囊切除术麻醉的临床研究

为观察异丙酚全凭静脉麻醉在老年人腹腔镜胆囊切除术 (LC)围麻醉期呼吸循环功能的变化 ,以评价其实用性和安全性 ,将 30例ASAⅠ～Ⅱ级患者 ,择期行LC手术 ,以微量泵持续静注异丙酚维持麻醉 (剂量递减法 10～ 8～ 6mg/kg·h-1) ,控制呼吸频率 16～ 2 5 /min ,人工气腹后保持轻度过度通气状态 ,连续监测呼吸循环功能各参数的变化。结果显示 :本组异丙酚平均总用量为 5 6 0± 12 8mg( 8.0 5± 2 .16mg/kg·h-1) ,麻醉诱导后SBP、DBP、MAP一过性降低 (P <0 .0 1) ,于插管后迅速恢复 ;CO2 气腹后PETCO2 开始上升并于 15min后达最高值但在正常范围 ,86 .6 7%的病例于拔管后 5～ 10min麻醉苏醒并能简单答话。认为异丙酚全凭静脉维持麻醉用于老年人LC并于气腹期轻度过度通气能维持呼吸循环功能的相对稳定 ,且苏醒快 ,术后恢复良好 ,具有实用性和安全性

Anesthesia forlaparoscopic cholecystectomy in the elderly patients

In order to evaluate the application and safety of propofol, 30 elderly patients with ASA I～II who underwent laparoscopic cholecystectomy (LC) were selected to observe their respiratory and hemodynamic changes during total intravenous anaesthesia. A micropump was used to keep continuous intravenous anesthesia (10～8～6 mg/kg*h-1, in a successive decreasing dosage). The respiratory rate was controlled within 16～25/min, keeping light excessive ventilation after APP and monitering continuouslly the respiratory and hemodynamic function. Results showed that the mean total propofol dose was 560±128mg (8.05±2.16mg/kg*h-1) and the SBP, DBP and MAP decreased shortly after induction (P<0.01). PETCO2 increased to the highest level 15 minutes subsequent to intubation but was still within the normal range. 86.67% patients recovered from anaesthesia in 5～10 minutes after extubation. This study suggests that total general intravenous anaesthesia with propofol in elderly patients undergoing LC produced a relative stability of respiratory and hemodynamic functions, as well as being safe and practical.