丙泊酚瑞芬太尼阿曲库铵全凭静脉复合麻醉在高龄危重患者全身麻醉中的作用

目的探讨丙泊酚、瑞芬太尼、阿曲库铵联合用于全凭静脉复合麻醉在高龄危重患者全身麻醉中的作用。方法30例拟行全身麻醉的高龄危重患者全部采用丙泊酚、瑞芬太尼、阿曲库铵全凭静脉气管插管全身麻醉,监测麻醉前、诱导后3 min、插管后1～2 min、插管后10 min的收缩压(SBP),舒张压(DBP),心率(HR),血氧饱和度(SpO2),记录麻醉后清醒时间及麻醉中知晓情况。结果30例患者诱导后表现出明显的血压下降和心率减慢,与麻醉前差异有统计学意义(P<0.05);气管插管1～2 min后,心率、血压能恢复到诱导前水平,所有患者麻醉维持过程中SBP、HR、SpO2无显著变化(P>0.05);麻醉后5 min内所有患者完全清醒,术中无l例诉术中知晓。结论丙泊酚、瑞芬太尼、阿曲库铵全凭静脉气管插管全身麻醉用于高龄危重患者是一种较安全,确实有效的麻醉方法。

Application of Total Venous Anesthesia with Propofol, Remifentanil and Atravurium to Elderly Critical Patients

Objective To explore the application of total venous anesthesia with propofol,remifentanil and atravurium to elderly critical patients.Methods Total venous anesthesia with propofol,remifentanil and atravurium as induction was applied to 30 elderly critical patients,on whom general inhalation anesthesia via endotracheal intubation was to be administered.The Parameters,including systolic blood presure(SBP),diastolic blood presure(DBP),heart rate(HR) and oxygen saturation of pulse(SpO2),were monitored at various time points.The time of return to consciousness,as well as the perception during the course of anesthesia,was recorded.Results The patients suffered from decreases in blood presure and HR after the induction,which were statistically significant(P<0.05);1-2 minute(s) later after the endotracheal tube was intubated,the blood presure and HR returned to the levels before the induction,and in the maintenance of general anesthesia,no significant changes in SBP,HR and SpO2 occurred(P>0.05);all the patients became wholly conscious within five minutes after the finish of anesthesia.None complained of perceptivity during operation.Conclusion Total venous anesthesia with propofol,remifentanil and atravurium to elderly critical patients is a safe and effective inducing approach to general anesthesia via endotracheal intubation.