ABSTRACT
Objective:To observe the effect of intravenous anesthesia with target-controlled infusion (TCI) of remifentanil combined with propofol on hemodynamics in middle-aged and elderly patients with intracranial aneurysm clipping. Methods:Totally 40 cases of middle-aged and elderly patients undergoing intracranial aneurysm clipping were divided into combined anesthesia group and propofol group according to the random number table. The combined anesthesia group was treated with remifentanil combined with propofol target intravenous anesthesia, and propofol group was treated with propofol intravenous hypotension. The changes of mean arterial pressure(MAP),heart rate(HR),cardiac output(CO) and heart index(CI) before the induction of anesthesia (T1), tracheal intubation (T2), before aneurysm clipping(T3), after aneurysm clipping(T4) and extubation (T5) were observed. The anesthesia maintenance time, extubation time, postoperative wake-up time and adverse reactions were compared. Results:There were no significant differences in MAP and HR between the groups(P > 0.05), the levels of MAP,HR,CO and CI at T2,T3and T4were significantly lower than those at T1,and CO and CI were significantly lower in combined group than those in propofol group(P < 0.05). Conclusion:TCI remifentanil combined with propofol can maintain hemodynamic stability, shorten extubation time and wake-up time, and reduce the incidence of adverse reactions in the patients with intracranial aneurysm clipping.
ABSTRACT
Objective To compare the anesthetic effects of remifentanil and fentanyl in elderly patient undergoing transurethral electro-vaporization of the prostate.Methods Eighty cases of the elderly patients (age ≥60 years) with transurethral resection of the prostate operation in the hospital were randomly divided into remifentanil group(R group,n =40) and fentanyl group (F group,n =40).Patients in R group and F group were administrated remifentanil and fentanyl respectively for induction and maintenance of anesthesia.The following indices were recorded including the changes of emodynamics (lood pressure,heart rate) in before-and after-anesthesia,postoperative recovery (spontaneous breathing recovery time,open the recovery time,extubation time) and the adverse reaction within 24 hours after operation (awareness during operation,nausea,vomiting).Results Blood pressures,heart rate of after-anesthesia in R group were lower than that in before-anesthesia and F group,the difference were significant(Blood pressures:F within group =58.306,P within group =0.000,F interactive group =142.450,p interactive group =0.000,F between group =7.417,P between group =0.010;heart rate:F within group =41.512,P within group =0.000,F interactive group =269.103,P interactive group =0.000,F between grouP =39.703,P between group =0.000).Spontaneous breathing recovery time,opening eye time and extubation time in group R were significantly shorter than that of F group (Spontaneous breathing recovery time:(7.5 ± 1.3) min vs.(10.7 ± 3.1) min,t =3.011 ; Opening eye time:(13.5 ± 3.2) min vs.(18.3 ± 5.2) min,t =2.611 ; Extubation time:(24.4 ± 5.5) min vs.(29.2 ± 7.1) min,t =2.696 ; all P ＜ 0.05).No significant differences were found in R and F group in terms of intraoperative awareness postoperative nausea,vomiting (P ＞ 0.05).Conclusion Remifentanil used in elderly patients with transurethral electro-vaporization of the prostate was safer and more effective than fentanyl.Meanwhile postoperative recovery in Remifentanil patient was more rapidly.Therefore Remifentanil was ideal drug during the process clinical anesthesia.