丙泊酚复合曲马多预防老年高血压患者全麻拔管期心血管反应的临床观察

目的观察丙泊酚复合曲马多对老年高血压患者气管拔管时心血管反应的预防作用。方法择期胃癌根治手术合并原发性高血压老年患者24例,随机均分为观察组（T组）和对照组（C组）。T组于气管拔管前给予静脉注射丙泊酚0.1～0.3mg/kg和曲马多1mg/kg,3～5min后予吸痰拔管;C组不用药。观察围拔管期BP、RR、HR、SpO2、拔管时间、清醒时间、躁动发生情况及有无恶心、呕吐等不良反应。结果 T组拔管时BP、RR、HR、SpO2平稳,明显优于C组,恶心、呕吐、躁动发生例数也少于C组（P〈0.05）;两组间拔管时间、清醒时间差异无统计学意义。结论老年高血压患者在拔除气管导管前给予小剂量丙泊酚复合曲马多能有效预防气管拔管时的心血管反应,且不良反应少。

Using of Propofol and tramadol can prevent cardiovascular effects induced by anesthesia extubation in elderly patients with hypertension

Objective The purpose of this study is to observe the prevention effect of combination using of propofol and tramadol on anesthesia extubation induced cardiovascular effects in elderly patients with hypertension.Methods 24 cases of gastric cancer patients with primary hypertension were randomized divided into treatment gropu（T group）and controlled group（C group）.Before tracheal extubation,T group was given intravenously with propofol 0.1～0.3mg/kg and tramadol img/kg.Recoeded the tracheal extubation BP,RR,HR,SpO2,extubation time,awake time,agitation,and the incidence of nausea,vomiting,and other adverse reactions.Results The extubation BP,RR,HR,SpO2 of group T were keeping more stable than that of group C.The number of patients with nausea and vomiting,restlessness in group T was less than C group（P0.05）.Extubation time and awake time between the two groups were not statistically significant.Conclusion The using of small doses of propofol and tramadol in the elderly patients with hypertension can effectively prevent tracheal extubation induced cardiovascular response,and with few adverse reactions.