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时间:2020-04-17
《不同麻醉方法老年手术患者苏醒期躁动比较.pdf》由会员上传分享,免费在线阅读,更多相关内容在应用文档-天天文库。
1、-500·徐州医学院学报ACTAACADEMIAEMEDICINAEXUZHOU2014,34(8)不同麻醉方法老年手术患者苏醒期躁动比较张茂银,刘苏,刘功俭(徐州医学院附属医院麻醉科,江苏徐州221002)摘要:目的比较全凭静脉麻醉和静吸复合麻醉老年手术患者苏醒期躁动情况,探讨降低术后躁动的麻醉方法。方法择期手术老年患者40例,ASAI~Ⅱ级,完全随机法分为2组,每组20例,分别给予全凭静脉麻醉(A组)和静吸复合麻醉(B组)。2组患者全麻诱导成功后插入气管导管。A组麻醉维持采用静脉泵注丙泊酚4~6mg·kg~-h~、瑞芬太尼10~20g·kg一·h和顺式阿曲库铵0.1~0.2mg·kg
2、~·h~。B组麻醉维持采用吸入1%3%七氟醚并复合静脉泵注丙泊酚2~4mg·kg~·h一、瑞芬太尼6—10Ixg·kg~·h和顺式阿曲库铵0.10.2mg·kg~·h~。保持2组患者的血流动力学平稳,并用肌松监测仪监测使2组患者达到相同的肌松程度,2组患者手术结束前5rain给予芬太尼2p.g/kg,同时静脉接镇痛泵进行术后镇痛,所有患者未使用催醒药。记录2组患者拔管时间和躁动评分。结果A组拔管时间、躁动发生率明显低于B组,差异有统计学意义(P<0.05)。结论全凭静脉麻醉可以降低老年手术患者麻醉苏醒期躁动的发生率。关键词:全凭静脉麻醉;静吸复合麻醉;七氟醚;老年;苏醒期躁动中图分类号:
3、R614.2文献标志码:A文章编号:1000—2065(2014)08—0500—03EfectsofdiferentanestheticmethodsonemergenceagitationinelderlypatientsZHANGMaoyin,LIUSu,LIUGongjian(DepartmentofAnesthesiology,theAfiliatedHospitalofXuzhouMedicalCollege,Xuzhou,Jiangsu221002,China)Abstract:ObjectiveTocomparetheeffectsofdifferentanestheti
4、cmethodsonemergenceagitation(EA)inelder—lypatients.MethodsFortyASAI—IIpatients(24menand16women)aged65—78yearswererandomlyreceivedei—therintravenousgeneralanesthesia(groupA,n:20)orcombinedintravenousinhalationanesthesia(groupB,n=20)beforesurgery.GroupAwasinfusedwith4—6mg·kg~·hpropofo1.10—20p,g·kg~
5、·h~remifentaniland0.1—0.2mg·kg一·h一syn—atracurium.GroupBwasmaintainedwithl%一3%sevofluranethroughinhalationcon—binedwith2—4mg·kg一·h一propofo1.6—10Ixg·kg一·h一remifentaniland0.1—0.2mg·kg一·h一。syn—at—racuriumthroughintravenousinfusion.Duringoperation,allpatientspresentedstablehemodynamicsandthesamedegree
6、ofmusclerelaxation.Allpatientswereintravenouslyinjectedwith2kgfentanyl5minbeforetheendofoperation,whilePCIAwereadoptedforpost—operativeanalgesia.Therestlessnessscore(RS)andthetimeofextubationwerere—corded.ResultsIngroupA,therestlessnessscore(RS)andthetimeofextubationweresignificantlylessthanthose
7、ingroupB(P<0.05).ConclusionIntravenousgeneralanesthesiacansignificantlyreducetheincidenceofemergenceagitationinelderlypatientsaftersurgery.Keywords:intravenousgeneralanesthesia;combinedintravenousinhalationanesthesia;s
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