Effects of different dose of remifentanil with laryngeal mask airway ventilation on total hip-arthroplasty in the aged patients / 中国医师进修杂志

ABSTRACT

Objective To investigate the clinical effects of different dose of remifentanil with double-tube type laryngeal mask airway (LMA) ventilation in the aged patients undergoing total hip-arthroplasty (THA).Methods Sixty ASA class Ⅰ-Ⅱ grade patients undergoing THA were enrolled in the study.The patients were divided into three groups according to remifentanil dose with 20 cases each,0.2 μ g/ (kg· min)group,0.3 μ g/(kg· min) group and 0.4 μ g/(kg· min) group.Heart rate and mean arterial pressure (MAP)were measured immediately before anesthesia induction,immediately after anesthesia induction,immediately after inserting LMA,the set of operation,15 min during operation and discontinuation of anesthetic.Results All patients were successfully operated without intraoperative awareness.In 0.2 μ g/(kg·min) group,the patients suffered from the heart rate and MAP fluctuations,the high incidence of body movement (45.0％,9/20),and the maximum amount of propofol [(82.4 ± 21.6) mg].In 0.3 μg/(kg· min) group,heart rate and MAP had the better fluctuation,and patients might wake up faster postoperatively.In 0.4 μ g/(kg· min) group,heart rate and MAP significantly decreased,the amount of efedrina [(5.2 ± 4.3) mg] was the largest in the three groups,the recovery time [(5.2 ± 1.3) min] was the longest Conclusion Remifentanil 0.3 μg/(kg·min) compound with propofol with double-tube type LMA can be used for total intravenous anesthesia in the elderly patients with THA,with hemodynamic stability,fewer complications,and reliable ventilation.