摘要
目的探讨依托咪酯与七氟烷麻醉在老年脊柱手术患者中的应用效果。方法前瞻性研究。抽取2023年8月至2024年8月于西安交通大学第一附属医院榆林医院行脊柱手术的154例老年患者,其中采用静脉注射依托咪酯行麻醉诱导的77例为依托咪酯组,采用吸入七氟烷行麻醉诱导的77例为七氟烷组。比较两组患者的临床指标、血流动力学指标[收缩压(SBP)、舒张压(DBP)、心率(HR)]、脑氧代谢指标[颈静脉球血氧饱和度(SjvO 2)、动脉-颈内静脉血氧含量差(AVDO 2)、脑氧摄取率(CERO 2)]、认知情况[简易智能状态检查量表(MMSE)评分]、视觉模拟评分法(VAS)评分。结果两组术中出血量、术后自主呼吸恢复时间及唤醒时间比较差异未见统计学意义(P>0.05)。术后,七氟烷组SBP、DBP高于依托咪酯组(P<0.05),但两组HR比较差异未见统计学意义(P>0.05)。术后,依托咪酯组SjvO 2高于七氟烷组(t=3.00,P<0.05),AVDO 2、CERO 2均低于七氟烷组(t=-10.93、-5.52,P均<0.001)。术后12、24 h,两组MMSE评分比较差异未见统计学意义(P>0.05);术后12、24 h,依托咪酯组VAS评分均低于七氟烷组(t=-12.89、-23.34,P均<0.001)。结论相较于七氟烷麻醉,采用依托咪酯麻醉行脊柱手术的老年患者术后SBP、DBP、HR更稳定,可降低脑氧代谢及术后疼痛。
ObjectiveTo investigate the effect of etomidate and sevoflurane anesthesia in elderly patients undergoing spinal surgery.MethodsA total of 154 elderly patients who underwent spinal surgery in Yulin Hospital,the First Affiliated Hospital of Xi’an Jiaotong University from August 2023 to August 2024 were selected for the prospective study.Among them,77 patients who were induced by intravenous injection of etomidate were enrolled in the etomidate group,and 77 patients who were induced by inhalation of sevoflurane were enrolled in the sevoflurane group.The clinical indexes,hemodynamic indexes including systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR),cerebral oxygen metabolism indexes including jugular bulb venous oxygen saturation(SjvO 2),arterial-jugular venous oxygen content difference(AVDO 2)and cerebral oxygen extraction rate(CERO 2),cognitive status assessed by mini-mental state examination(MMSE)score,and visual analogue scale(VAS)score were compared between the two groups.ResultsThere was no significant difference in intraoperative blood loss,postoperative spontaneous breathing recovery time,and wake-up time between the two groups(P>0.05).The sevoflurane group had higher SBP and DBP than the etomidate group(P<0.05),but there was no significant difference in HR between the two groups after surgery(P>0.05).After operation,the SjvO 2 in the etomidate group was higher than that in the sevoflurane group(t=3.00,P<0.05),while AVDO 2 and CERO 2 were lower than those in the sevoflurane group(t=-10.93,-5.52;both P<0.001).At 12 and 24 hours after surgery,there was no significant difference in MMSE scores between the two groups(P>0.05).At 12 and 24 hours after surgery,the VAS scores in the etomidate group were lower than those in the sevoflurane group(t=-12.89,-23.34;both P<0.001).ConclusionsCompared with sevoflurane anesthesia,the use of etomidate in elderly patients undergoing spinal surgery results in more stable SBP,DBP,and HR values after surgery;moreover,it can reduce cerebral oxygen metabolism,and lower postoperative pain.
作者
马宏
党炳文
Ma Hong;Dang Bingwen(Department of Anesthesia Surgery,Yulin Hospital,the First Affiliated Hospital of Xi’an Jiaotong University,Yulin 719000,China)
出处
《中国实用医刊》
2025年第6期45-48,共4页
Chinese Journal of Practical Medicine
关键词
依托咪酯
七氟烷
麻醉
老年脊柱手术
疗效
Etomidate
Sevoflurane
Anesthesia
Spine surgery for the elder
Curative effect
作者简介
通信作者:党炳文,Email:qunmushewan@126.com。
