摘要
目的:探讨依托咪酯联合丙泊酚全凭静脉麻醉维持对老年患者硬质气管镜介入治疗的效果及安全性。方法:选择2022年12月-2024年6月在厦门医学院附属第二医院行择期硬质气管镜介入治疗的患者124例,随机分为两组,每组62例。试验组以依托咪酯联合丙泊酚(容量1∶1混合液)麻醉诱导及维持,对照组以丙泊酚麻醉诱导及维持。记录两组各时间点[麻醉前(T_(0))、置镜入声门时(T_(1))、置镜后10 min(T_(2))、手术结束时(T_(3))]的HR和MAP。比较两组术中低血压、高血压、心动过缓、血管活性药物干预情况,以及苏醒时间、拔管时间、手术时间和术后恶心呕吐发生情况。应用简易智力状态检查量表(mini-mental state examination,MMSE)评估患者认知功能。结果:T_(1)、T_(2)、T_(3)时间点,对照组HR、MAP均低于试验组(P<0.05);试验组术中低血压发生率及血管活性药物干预率明显低于对照组(P<0.05);试验组拔管后30 min及术后1 d的MMSE评分明显高于对照组(P<0.05);试验组苏醒时间及拔管时间较对照组早(P<0.05)。结论:依托咪酯联合丙泊酚全凭静脉麻醉维持应用于老年患者硬质气管镜介入治疗,患者术中循环更稳定,低血压发生率明显降低,并可减轻术后早期认知功能损害。
Objective:To investigate the effect and safety of total intravenous anesthesia maintenance with Etomidate combined with Propofol on interventional therapy of rigid bronchoscopy in elderly patients.Method:A total of 124 patients who underwent interventional therapy of rigid bronchoscopy in the Second Affiliated Hospital of Xiamen Medical College from December 2022 to June 2024 were randomly divided into two groups,with 62 cases in each group.The experimental group received anesthesia induction and maintenance by Etomidate combined with Propofol(volume 1∶1 mixture).The control group received anesthesia induction and maintenance by Propofol.The HR and MAP of the two groups were recorded at each time point[before anesthesia(T_(0)),when putting the endoscope into glottis(T_(1)),10 min after endoscope placement(T_(2)),and at the end of the surgery(T_(3))].The conditions of hypotension,hypertension,bradycardia,vasoactive drugs intervention during operation,and the recovery time,extubation time,operation time,and the occurrence of postoperative nausea and vomiting were compared between the two groups.Mini-mental state examination(MMSE)was used to evaluate the cognitive function of patients.Result:At T_(1),T_(2) and T_(3) time points,the HR and MAP of the control group were lower than those of the experimental group(P<0.05).The incidence of intraoperative hypotension and the intervention rate of vasoactive drugs in the experimental group were significantly lower than those in the control group(P<0.05).The MMSE scores of the experimental group 30 min after extubation and 1 day after operation were significantly higher than those of the control group(P<0.05).The recovery time and extubation time of the experimental group were earlier than those of the control group(P<0.05).Conclusion:Total intravenous anesthesia maintenance with Etomidate combined with Propofol is used in elderly patients with interventional therapy of rigid bronchoscopy,the patient's intraoperative circulation is more stable,the incidence of hypotension is significantly reduced,and the early postoperative cognitive impairment can be alleviated.
作者
杨娜瑜
徐晓峰
吕静
单立刚
YANG Nayu;XU Xiaofeng;LYU Jing;SHAN Ligang(Department of Anesthesiology,the Second Affiliated Hospital of Xiamen Medical College,Xiamen 361021,China;不详)
出处
《中国医学创新》
2025年第21期32-36,共5页
Medical Innovation of China
基金
2022年福建省教育厅中青年教师教育科研项目(科技类)(JAT220415)。
关键词
依托咪酯
丙泊酚
全凭静脉麻醉
老年患者
硬质气管镜
Etomidate
Propofol
Total intravenous anesthesia
Elderly patients
Rigid bronchoscopy
