三种用药方法在老年患者全麻诱导的应用比较.docVIP

精品论文 参考文献 三种用药方法在老年患者全麻诱导的应用比较 李刚 陈晓艳 黄静 （泸州医学院附属医院麻醉科 四川泸州 646000） 【摘要】目的 比较三种用药方法在老年患者全麻诱导中的应用，探讨最适合老年病人的全麻诱导用药方法。方法 90例年龄gt;65岁的择期手术全身麻醉病人，随机分为3组：丙泊酚2mg/kg组（P组），咪达唑仑及丙泊酚组（MP组）：咪达唑仑0.02mg/kg+丙泊酚1.5mg/kg，咪达唑仑及依托咪酯组（ME组）：咪达唑仑0.02mg/kg+依托咪酯0.3mg/kg，观察诱导前、诱导后、插管后患者的收缩压、舒张压、心率和BIS值。结果 三种全麻诱导方法麻醉诱导前后及插管后BIS值、HR变化均无统计学差异（Pgt;0.05），而与ME组比较，P组，MP组麻醉诱导前后SBP，DBP变化幅度均大于ME组，具有明显的统计学差异（均Plt;0.01）。结论 老年患者采用依托咪酯0.3mg/kg伍用咪达唑仑0.02mg/kg的诱导方法对循环的影响程度比其他两种诱导方法小，是值得推荐的麻醉诱导方法。 【关键词】老年 全麻诱导 咪达唑仑 丙泊酚 依托咪酯 【中图分类号】R614 【文献标识码】A 【文章编号】2095-1752（2013）24-0087-02 The comparation of three induction methods of general anesthesia in elder patients. Li Gang, Chen Xiaoyan, Huang Jing. Department of anesthesiology ,affiliated hospital of Luzhou Medical Collage, Luzhou, Sichuan,646000,china 【Abstract】 :Objective To compare three induction methods of general anesthesia in elder patients, then to choose the best one for clinical application. Methods ninety patients aged beyond 65 yrs old undergoing elective surgery under general anesthesia were randomly divided into three groups. The group of propofol 2mg/kg (group P), the group of midazolam 0.02mg/kg and propofol 1.5mg/kg(group MP), the group of midazolam 0.02mg/kg and etomidate 0.3mg/kg (group ME). the SBP, DBP, HR and BIS were measured before or after induction, after intubation. Results The BIS and HR have no significance in three groups before or after induction, after intubation(Pgt;0.05), but the changes of SBP，DBP were higher than those in group ME before or after induction (Plt;0.01) . Couclusion In elder patients, Circulation inhibition is lowest by induction of midazolam 0.02mg/kg combined etomidate 0.3mg/kg than other methods. 【Key words】 elder patient induction of general anesthesia midazolam propofol etomidate 随着社会的发展，人均寿命不断的提高，我国与世界其他一些国家一样面临人口老龄化的问题。由于人口老年化和医疗卫生技术的进步，临床上需行外科手术的老年病人越来越多，据统计，65岁以上的老年人中，半数以上在去世前至少要经历一次手术治疗，而目前对老年病人的麻醉诱导用药方法多种多样。那么，哪种方法更适合老年病