七氟烷联合瑞芬太尼在老年口腔恶性肿瘤患者麻醉中的应用

目的 观察老年口腔恶性肿瘤手术麻醉维持期联合使用七氟烷和瑞芬太尼对术中血流动力学和术后苏醒期的影响。方法 40例老年口腔恶性肿瘤患者随机分为P组和S组,每组20例。P组全程采用丙泊酚-芬太尼静脉麻醉;S组采用七氟烷-瑞芬太尼维持麻醉。观察手术开始后1h、3h时心率、平均动脉压、自主呼吸恢复时间、清醒时间和苏醒期躁动与恶心呕吐情况。结果 术中两组均能维持血压和心率稳定,S组血压略低于P组(P<0.05)。术后S组自主呼吸恢复时间大于P组(P<0.01);S组清醒时间小于P组(P<0.01);两期组苏醒躁动例数无统计学差异(P>0.05);所有患者苏醒期均未发现恶心呕吐。结论 老年口腔恶性肿瘤手术麻醉维持期使用七氟烷和瑞芬太尼是安全可行的,能加快患者术后苏醒,且不增加麻醉并发症的发生率。?

Application of sevoflurane combined remifentanil in anesthesia of elderly oral malignant tumor patients

Objective To observe the effects of sevoflurane combined remifentanil on hemodynamic and awakening periods of elderly oral malignant tumor patients in anesthesia maintenance phase.Methods 40 cases of elderly patients with oral malignant tumor were randomly divided into group P and group S,with 20 cases in each group.Propofol-fentanil total intravenous anesthesia was employed throughout the whole course in Group P,while sevoflurane-remifentanil was adoped to maintain anesthesia in group S.The HR,MAP after the operation 1 h,3 h,breathing recovery time,awaking time,restlessness,nausea and vomiting during awakening period were observed.Statistical analysis was done by Stata8.2,and P≤0.05 was considered to be statistically significant.Results The HR and MAP could be steady in both groups.MAP of group S was a little lower than that in group P（P〈0.05） .The recovery time of spontaneous breathing in group S was longer than that in group P（P〈0.01） .The awakening time of group S was shorter than that of group P （P〈0.01） .Restlessness cases in each group had no significant difference（P〈0.05） .There were no nausea and vomiting in both groups during awakening period.Conclusion The application of sevoflurane combined with remifentanil to elderly malignant oral surgery receivers to maintain anesthesia,is safe and feasible,which can speed up the patient to regain consciousness.And in the meantime anesthesia complications did not increase.