心功能Ⅱ～Ⅲ级老年患者的全麻应用瑞芬太尼联合异丙酚双通道靶控输注临床效果观察

目的 探讨对心功能II～III级老年患者采用瑞芬太尼联合异丙酚双通道靶控输注全麻的临床效果.方法 120例心功能II～III级行胆囊切除手术老年患者随机分为等量两组,实验组进行瑞芬太尼联合异丙酚双通道靶控输注全麻,对照组进行七氟醚吸入全麻,监测患者各时点血液动力学变化,记录起效、苏醒时间和拔管后不良反应情况.结果 实验组各时点的血液动力学变化与对照组相比均无显著差异,起效及苏醒时间均短于对照组,除心动过缓无显著差异外,其他不良反应均少于对照组(P<0.05).结论 老年患者应用瑞芬太尼联合异丙酚双通道靶控输注全麻,能抑制心血管应激反应,维持血液动力学的稳定,且恢复迅速,值得推广使用.

Study on application of remifentanil combined with target-controlled infusion of propofol dual channel in general anesthesia for elderly patients with cardiac function II - III level

Objective To explore the Clinical effect of remifentanil and target-controlled infusion（TCI） of propofol for general anesthesia in elderly patients with cardiac function（NYHA） Ⅱ～Ⅲ.Methods One hundred and twenty elderly patients with cardiac function（NYHA） Ⅱ～Ⅲ were randomly divided into 2 groups,60 cases in each group.Patients in experimental group were used with remifentanil and TCI of propofol for general anesthesia,and patients in control group were inhaled with sevoflurane.Hemodynamic changes were monitored,and time for starting anesthetic effect and awakening time and side effects were recorded.Results There was no significant difference in experimental group during different time points of anesthesia.The time for starting anesthetic effect and awakening time in patients of experimental group were faster than those of patients in control group,and they had fewer side effects except bradycardia.Conclusion Remifentanil and target-controlled infusion of propofol for general anesthesia can inhibit cardiovascular stress response and maintain the stability of hemodynamics with quick recovery,and it is worthy to be popularized.