参麦注射液对老年手术患者丙泊酚全麻诱导期循环及呼吸功能的影响

目的 观察参麦注射液对老年手术患者丙泊酚全麻诱导期循环功能和呼吸功能稳定性的干预作用.方法 80例择期手术的老年患者随机分为参麦组和对照组各40例.参麦组于丙泊酚全麻诱导前用参麦注射液1ml/kg加入250ml生理盐水静脉滴注,对照组予以250ml生理盐水静脉滴注.然后实施丙泊酚全麻诱导、气管插管、麻醉维持及手术.记录两组患者入室时(T1)、给药后(T2)、全麻诱导前(T3)、插管前(T4)、插管后30min(T5)的收缩压(SBP)、舒张压(DBP)、心率(HR)、中心静脉压(CVP)、动脉血氧饱和度(SaO2)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、心电图(ECG)ST段水平和麻醉诱导期麻黄碱和阿托品的使用剂量和频率. 结果 与本组T1比较,参麦组及对照组T2、T3时间点CVP明显升高(P＜0.05),T4、T5时间点SBP、DBP、PaO2降低,PaCO2、HR升高(P＜0.05或P＜0.01).两组间比较,T4、T5时间点SBP、DBP、HR、PaCO2、PaO2差异均有统计学意义(P＜0.05).两组患者心电图疗效比较,参麦组总有效率90.9％,对照组总有效率20.0％,差异有统计学意义(P＜0.01).两组患者麻黄素及阿托品的用量及使用率比较,差异有统计学意义(P＜0.05).结论 参麦注射液用于老年患者丙泊酚全麻诱导期能减少循环及呼吸功能的波动程度,使丙泊酚的临床应用更加趋于安全.

Effect of Shenmai Injection on the Circulation and Respiration during Propofol Induction of General Anesthesia for Elderly Operative Patients

Objective To observe the effect of Shenmai Injection [ Injection of Renshen (Radix Ginseng) andmaidong (Radix Ophiopogonis)] on the stability of circulatory function and respiratory function during the propofol induction of general anesthesia for elderly operative patients.Methods Eighty aged patients scheduled to accept operation under general anesthesia were randomized into Shenmai group and control group with fourty in each.The Shenmai group received Shenmai Injection 1ml/kg into 250ml saline intravenously,while the control group received only 250ml normal saline before propofol anesthesia induction.Then,the propofol induction,intubation,anesthesiamaintain,and operation were performed.The systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR),central venous pressure (CVP),arterial blood oxygen saturation (SaO2),partial pressure of oxygen in arterial blood (PaO2),partial pressure of carbon dioxide in arterial blood (PaCO2),and STsegment of ECG were observed at the time of entering into the operating room (T1),ending the medication (T2),before the induction (T3),before intubation (T4) and 30minutes after intubation (T5) of both groups were recorded.The dose and frequency of atropine and ephedrine applied in the induction were also observed.Results Comparing with the ingroup T1,CVP of both groups at T2 and T3 was significantly increased (P<0.05),while the SBP,DBP,and PaO 2 decreased (P<0.05) and the PaCO 2 and HR increased (P<0.05) at T4 and T5.SBP,DBP,HR,PaCO2,and PaO2 between groups at T4 and T5 were significantly different (P<0.05).Concerning the effect on electracardiogram,the total effective rate of the shenmai group and the control group was 90.9% and 20.0% respectively,the difference between was statistically significant (P<0.01).The dose and frequency of atropine and ephedrine application of both groups was significantly different (P<0.01).Conclusion Application of Shenmai Injection in the propofol induction of general anesthesia in elderly operative patients can reduce the fluctuation of circulatory function and respiratory function,making the safe use of propofol for anesthesia.