【摘 要】
：
目的:探讨老年患者长时间麻醉后苏醒迅速平稳的麻醉方法.方法:50例胸腹手术的高龄重危患者,65岁以上,ASA分级Ⅱ～Ⅲ级,手术时间>3h.随机分为异丙酚复合芬太尼(A)组、异丙酚复合
【机 构】
：
江西省萍乡市人民医院麻醉科,337000
论文部分内容阅读
目的:探讨老年患者长时间麻醉后苏醒迅速平稳的麻醉方法.方法:50例胸腹手术的高龄重危患者,65岁以上,ASA分级Ⅱ～Ⅲ级,手术时间>3h.随机分为异丙酚复合芬太尼(A)组、异丙酚复合异氟醚(B)组、七氟醚复合瑞芬太尼麻醉(C)组、异丙酚复合舒芬太尼(D)组.麻醉维持首先根据B IS监测来分别调节七氟醚,异氟醚的吸入浓度或异丙酚,瑞芬术尼的静脉靶控浓度,B IS维持在45～55之间,手术结束后停止麻醉药.术中平均动脉压大于100mmHg或低于60mmHg分别视为高血压或低血压.术后应用了曲马多复合芬太尼进行超前镇痛同时应用昂丹司琼镇吐.观察三组的拔管时间、苏醒时间、定向力恢复时间、简单神经病学评估恢复时间等.结果:七氟醚复合瑞芬太尼麻醉(C)组拔管时间、苏醒时间、定向力恢复时间、简单神经病学评估恢复时间要明显快于其他三组(P<0.05).结论:七氟醚复合瑞芬太尼麻醉可以加快长时间老年危重患者的麻醉苏醒,尽快拔管后安返病房,使长时间手术麻醉具有短时间麻醉的苏醒优势,减少病人住院时间和住院费用.
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