不同麻醉方法对老年高血压患者循环功能及苏醒的影响

目的比较两种不同麻醉方法对老年高血压患者循环功能及苏醒的影响。方法选择择期上腹部手术老年高血压患者60例,ASA~级,随机分为全麻组(A组)和浅全麻联合硬膜外麻醉组(B组),每组30例。诱导前硬膜外给药2%利多卡因5ml,再行全麻诱导。全麻用药两组相同。分别记录诱导前(T1)、插管时(T2)、插管后5min(T3)、术中探查(T4)、拔管时(T5)、拔管后5min(T6)6个时间点的SBP、DBP、HR以及术后患者呼吸功能恢复情况和苏醒时间。结果A组在T2、T4、T5时SBP、DBP、HR均高于B组(P<0.05),全麻用药量B组明显少于A组(P<0.05),B组患者的术毕苏醒时间明显快于A组(P<0.05)。结论在老年高血压患者上腹部手术中,通过浅全麻联合硬膜外麻醉方法可维持血液动力学稳定,减轻应激反应,加快患者苏醒时间。

The effects of different anesthetic techniques on circulatory function and recovery in the older hypertensive patients

Objective: To compare the effects of different anesthetic techniques on circulatory function and recovery in the older hypertensive patients.Methods:Sixty older hypertensive patients, ASA gradeⅡ～Ⅲ,undergoing surgery were divided randomly into general anesthesia group (group A)and combined general anesthesia with epidural block group (group B) with 30 casesin in each.5 ml lidocaine was added after induction. The general anesthesia durgs of both groups were similar in induction and maintenance.SBP,DBP,HR were recorded. Result:In group A,SBP,DBP and HR were increased at T2、T4、T5 compared with group B(P<0.05).The amount of propofol used was significantly less in group B than that in group A(P<0.05).The recovery was faster in group B than that in group A(P<0.05). Conclusion:The depth of general anesthesia combined with epidural block in the older hypertensive patients is feasible with an advantage of keeping hemodynamics stable.