老年手术患者应用丙泊酚复合瑞芬太尼喉罩麻醉的临床效果观察

目的：探讨靶控输注丙泊酚复合瑞芬太尼喉罩麻醉在老年手术患者中的临床应用效果，为临床麻醉提供参考。方法：选取127例老年手术患者作为研究对象，随机分为A、B、C3组，A组43例（采用瑞芬太尼复合丙泊酚麻醉，喉罩通气）、B组42例（采用丙泊酚麻醉，喉罩通气），C组42例（采用瑞芬太尼复合丙泊酚麻醉，面罩通气），均采用靶控输注静脉麻醉法。观察麻醉诱导时间、术中反应、麻醉效果、镇静效果评分、苏醒时间、认知功能以及不良反应发生率等指标。结果：丙泊酚总用量：A组为（335．2±56．4）mg，B组为（466．5±64．8）mg，C组为（334．8±59．7）mg，经方差分析，差异有统计学意义，F=6．513，P〈0．05；Ramsay评分：A组6分的例数为37例（86．0％），B组为30（71．4％），C组为34（81．0％），经卡方检验，差异有统计学意义，X^2=5．832，P〈0．05；不良反应发生率：A组为5例（11．6％），B组为15例（35．7％），C组为7例（16．7％），经卡方检验，差异有统计学意义，X^2=7．546，P〈0．05。结论：老年手术患者应用丙泊酚复合瑞芬太尼喉罩麻醉效果显著，安全有效。

Clinical Application of Propofol Remifentanial Anesthesis with Laryngeal Mask Airway Ventilation in Old Operative Patients

Objective： To investigate the clinical application effect of target-controlled infusion with propofol remifentanil anesthesia with laryngeal mask airway ventilation in old operative patients. Methods： 127 old operative patients were chosen as research objects. They were randomly divided into A, B and C group. A group： propofol remifentanial anesthesia with laryngeal mask airway ventilation （n=43）. B group： propofol anesthesia with laryngeal mask airway （n=42）. C group： propofol remifentanial anesthesia with face mask airway ventilation （n=42）. Anesthesia was induced by target controlled infusion. Anesthesia induction time, intraoperative reaction, anesthetic effect, sedative effect score, recovery time, recovery quality and incidence of side effect were observed. Results： The dosage of propofol： （335.2± 56.4）mg in A group, （466.5± 64.8）mg in B group,（334.8± 59.7）mg in C group. The difference was statistically significant by analysis of variance （F=6.513, P〈0.05）. Ramsay score： The cases of 6 points were respectively 37 cases （86.0%）, 30 cases （71.4%） and 32 cases （81.0%） in A, B and C group. There was significant difference by Chi square（X^2 =5.832, P〈0.05）. Incidence of side effect： 5 cases （11.6% ） in A group, 15 cases （35.7%） in B group, 7 cases （ 16.7% ） in C group. There was significant difference by Chi square （X^2 =7.546, P〈0.05）. Conclusions： The effect of propofol remifentanil anesthesia with laryngeal mask airway ventilation in old operative patients is remarkable. It is safe and effective.