Clinical observation of sevoflurane for anesthetic induction in elderly patients / 中华老年医学杂志

ABSTRACT

Objective To observe the onset time,cardiovascular system reactions and side effects of anesthetic introduction with sevoflurane and to explore its reliability and safety in elderly patients. Methods Sixty American Society Anesthesiologists(ASA)Ⅰ～Ⅲ patients aged 65～78 years who were scheduled for selective operation were selected in the study.They were randomly divided into sevoflurane inhalation induction group(sevoflurane group)and propofol induction group (control group).In sevoflurane group,the concentration of inhaled sevoflurane was regulated according to downgrading method during the induction,and it was decreased by 1% every 30 seconds from the initial concentration of 7% to the maintained concentration of 4%.In control group,propofol was titrated by 1.5～2.5 mg/kg.When bispectral index(BIS)was≤60,sufentanil was administered intravenously and the patients were paralyzed with rocuronium and intubated.The extinction time of lash reflex and the achievement time of BIS≤60 in two groups were recorded.The mean arterial blood pressure(AMBP),heart rate(HR),oxygen saturation(Sp02)and BIS of the basic values before intubation,and 1 min,3 min,5 min after intubation were also recorded,respectively.The side effects during intubation such as laryngeal spasm,body movements,irritating cough,restless movement during intubation were noted.The consciousness during intubation and satisfaction with induction were followed in patients after operation. Results The extinction time of lash reflex and the achievement time of BIS≤60 were significantly longer in sevoflurane group than those in control group (both P＜0.01).In sevoflurane group.there were no differences in MBP and HR between 1 min postintubation and pre-intubation.Whereas,in control group,AMBP and HR were lower before intubation than basic values,and were higher 1 rain post-intubation than pre-intubation(P＜0.05).There were irritating cough cases both in sevoflurane group and in control group(5 vs.3),and there was no laryngeal spasm case.All patients were satisfied with the anesthesia and had no consciousness during intubation. Conclusions　Sevoflurane is a safe and effective induction agent and has little side effects.It is an ideal choice for elderly patients.