老年高血压患者术中靶控输注依托咪酯与丙泊酚的临床观察

目的对比观察老年高血压患者术中靶控输注依托咪酯、丙泊酚对血流动力学及术毕苏醒的影响。方法择期行腹腔镜手术老年高血压患者60例,随机分为依托咪酯组(E组)和丙泊酚组(P组),每组30例。E组靶控输注依托咪酯和复合瑞芬太尼进行麻醉诱导并维持,P组靶控输注丙泊酚和复合瑞芬太尼诱导并维持。记录麻醉前(T0)、插管前1 min(T1)、插管后2 min(T2)、置入腹腔镜后3 min(T3)、手术探查后3 min(T4)、拔管后3 min(T5)等6个时点的收缩压(SBP)、舒张压(DBP)和心率(HR)及苏醒指标、不良反应等。结果与T0比较,T1时点,SBP、DBP、HR均显著降低(P<0.05);且P组较E组显著下降(P<0.05);T3时点P组HR显著减慢(P<0.01)。两组不良反应发生率无统计学差异(P>0.05)。E组苏醒时间均明显长于P组(P<0.05)。结论 E组与P组比较,靶控输注依托咪酯更有利于老年高血压患者血流动力学稳定,但苏醒时间延长。

Application of Etomidate or Propofol Target Controlled Infusion in the Elderly Hypertensive Patients

Objective To compare with the effects of etomidate or propofol target controlled infusion(TCI)on hemodynamics and recovery in the elderly hypertensive patients.Methods Sixty elderly hypertensive patients with underwent laparoscopic operation were randomized into etomidate group(Group E)and propofol group(Group P),each group was 30 cases.Patients in Group E were induced and maintained with TCI etomidate and remifentanil,patients in Group P were induced and maintained with TCI propofol and remifentanil.The systolic blood pressure(SBP),diastolic blood pressure(DBP)、heart rate(HR)、recovery time index and adverse reaction were recorded before anesthesia induction(T0),l min before tracheal intubation(T1),2 min after tracheal intubation(T2),3 min after insert laparoscope(T3),3 min after exploration(T4)and 3 min after tracheal extubation(T5)respectively.Results Compared with T0,SBP,DBP and HR decreased significantly in both groups at time T1(P<0.05);but group E has a better hemodynamics than group P(P<0.05);HR in group P decreased significantly at time T3(P<0.01).There was no any significant difference in the side effect rate(P>0.05).The recovery time in group E was longer than that of group P(P<0.05).Conclusion Group E is easier to maintain stable hemodynamics than group P,but the recovery time may be prolonged in the elderly hypertensive patients.