Clinical Observation of Hypoxia Flow Sevoflurane Combined with Propofol for Elderly Abdominal Tumor Surgery in Saturation
10.6039/j.issn.1001-0408.2016.24.20
- VernacularTitle:饱和状态后低氧流量七氟醚联合丙泊酚用于老年腹部肿瘤手术的临床观察
- Author:
Xiangxue WAN
;
Qiuyan ZHENG
;
Zhiwen ZHENG
- Publication Type:Journal Article
- Keywords:
Hypoxia flow anesthesia;
Sevoflurane;
Propofol;
Abdominal tumor;
Cognitive dysfunction
- From:
China Pharmacy
2016;27(24):3374-3376
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To observe the anesthesia effect and safety of hypoxia flow sevoflurane combined with propofol for el-derly abdominal tumor surgery in saturation. METHODS:128 elderly patients took abdominal tumor surgery under general anesthe-sia were randomly divided into observation group(64 cases)and control group(64 cases). After routine anesthetic induction,the oxygen flow was adjusted to 6 L/min,vaporizer was adjusted to 2%,10 minutes after inhalation,the observation group was adjust-ed to 0.5 L/min,and control group was 1.5 L/min,all received 0.5 mg/L propofol by target-controlled infusion,continuous infu-sion of remifentanil,intermittent bolus injection of vecuronium 1-2 mg/times based on the intraoperative muscle relaxation. Heart rate(HR),mean arterial pressure(MAP),oxygen saturation(SpO2),central venous pressure(CVP),inspired oxygen concentra-tion(FiO2),end-tidal carbon dioxide partial pressure [p(CO2)] in 10 min(T0),intraoperative 1 h(T1),intraoperative 2 h(T2), end of surgery(T3)in 2 groups were observed;sevoflurane dosage,recovery time,restlessness,and blood urea nitrogen(BUN), serum creatinine (Cr),alanine aminotransferase (ALT) levels,incidence of early cognitive dysfunction before and after surgery and the incidence of adverse reactions in 2 groups were recorded. RESULTS:There were no significant differences in the HR, MAP,SpO2,CVP,FiO2 and p(CO2)in 2 groups at different time points(P>0.05). The sevoflurane dosage,recovery time,the incidences of cognitive dysfunction postoperative 3 h and 6 h and adverse reactions in observation group were significantly lower than control group,the differences were statistically significant (P<0.05). And there were no significant differences in the cases with restlessness and incidence of cognitive dysfunction postoperative 1 d and 3 d(P>0.05). After surgery,ALT levels in 2 groups were significantly higher than before,the difference was statistically significant(P<0.05),but there was no significant difference between 2 groups (P>0.05). There were no significant differences in preoperative ALT and preoperative and postoperative BUN and Cr between 2 groups(P>0.05). CONCLUSIONS:Hypoxia flow sevoflurane combined with propofol shows obvious anesthe-sia effect for elderly abdominal tumor surgery in saturation,with stable hemodynamics,it can reduce sevoflurane dosage,shorten the recovery time and reduce the incidence of early postoperative cognitive dysfunction,with good safety.