艾司洛尔降低老年患者全身麻醉中芬太尼用量及安全性探讨

目的: 观察艾司洛尔对老年患者全身麻醉期间芬太尼用量的影响及安全性。方法: 将 40 例ASAⅡ ~ Ⅲ级行关节置换术的老年患者, 随机分为2 组。C 组采用常用剂量的芬太尼、异氟醚全身麻醉 ;E 组诱导前静脉注射艾司洛尔 1 mg/kg,继以 25 μg^。kg^{-1 。}min^-1持续输注, 均使术中平均动脉压 (MAP) 、心率(HR) 在基础值 (100%±20%) , 脑电双频指数(BIS) 在 45 ~ 60。观察手术期间MAP 、HR、BIS 的变化 ;记录拔管后VAS 、Ram-say 评分;记录复苏时的咽喉反射时间(LRT) 、睁眼时间(EOT) 、拔管时间(ET) 、围术期用药情况,随访术中知晓等并发症。结果: E 组插管后 5 minHR、插管后 1 min BIS 小于 C 组(P <0.05) , 组间VAS 、Ramsay 评分相近 (P >0.05) 。E 组 LRT 、EOT 、ET 、芬太尼药量少于 C 组(P <0.05) , 组间并发症发生率相似(P >0.05) 。结论: 艾司洛尔减少老年患者全身麻醉期间芬太尼药量, 苏醒迅速且安全。

Administration of esmolol during operation decreased the consumption of fentanyl in senile patients and its safety

AIM: To evaluate the influences of perioperative esmolol administration upon the consump-tion of fentanyl in senile patients and its safety . METHODS: Forty ASAⅡ-Ⅲ old patients undergoing joint replacement were randomly assigned two groups of equal size .Rout fentanyl-isoflurane combined anesthe-sia was used in group C patients;Patients in the group E received an i .v.loading dose of esmolol 1 mg/kg be-fore anaesthesia induction and followed by infusion of 25 μg^。kg^{-1 。}min^-1 , MAP, HR were keeped within 20%of the baseline and BIS in 45-60 in both groups ;Observe intraoperative changes of MAP, HR, BIS, note VAS, Ramsay sedation score after extubation, note laryngeal reflex time(LRT) , eyes-opening time(EOT) , extubation time (ET) at resuscitation and follow the in-formation about drug consumption and perioperative complications.RESULTS: T 4 HR, T 2 BIS in group E were less than group C (P <0.05) ;VAS, Ramsay scores were similar between the two groups (P > 0.05) ;LRT, EOT, ET and intraoperative consump-tion of fentanyl in group E were obviously less than those in group C (P <0.05) , the rates of PONV and intraoperative awareness were similar between the two groups (P >0.05).CONCLUTION: Perioperative esmolol administration can reduce the intraoperative consumption of fentanyl during general anaesthesia in senile patients undergoing joint replacement, and that brings about quicker and safe resuscitation .