| Purpose:This thesis is trying to compare the hemodynamic effect of old patients with general anesthesia induction and trachea cannula under monitoring of BIS; it also tries to figure out the effect of remifentanil to sevoflurane concentration with certain level. Method:Choose 50 old patients(aged from 63 to 75) who are waiting for the selective operation of general anesthesia, separate them randomly according to target plasma concentration into five groups:R1, R2, R3,R4and R5, which stands for 1,2,3,4 and 5ng/ml of each group, the concentration of sevoflurane is 3%, do the infusion induction with remifentanil at the same time when the etomidate target plasma concentration comes to 0.6μg/ml, note the systolic pressure, diastolic pressure, MAP and heart rate(average before the induction and minimum during the induction) of T1(before the induction), T2 (when the BIS comes to 60), T3 (right before cannula), T4 (one minute after cannula) and T5 (three minutes after cannula), monitoring record the concentration of sevoflurane before and after breath. Results:The blood pressure and heart rate of R1,R2 during the intubation is higher than that of before induction and intubation(P<0.05), the difference of the blood pressure and heart rate before and after intubation of R3 is quiet, and circulation restrain appears during induction of R4,R5. The ETBIS60% of the five groups of patients are 2.33%,2.18%,1.49%,1.14%,0.97%; there is a clear reduction of ET BIS60% for R3,R4,R5 compare to R1. Conclusion:Both TCI remifentanil and sevoflurane can be safely applied on induction of general anesthesia of old patients, when it comes to certain ramsay, the end-tidal concentration of sevoflurane will reduce while the target plasma concentration of remifentanil will increase; remifentanil can active suppress the severe reaction of trachea cannula and maintain hemodynamic stability of old patients with sevoflurane inspiratory intubation. |
PDF Full Text Request