| Objective:The purpose of this article was to study the optimal dosage of etomidate at bispectral index-guided induction of general anesthesia in elderly patients and to observe the effect of etomidate on hemodynamics and compare the same with young people.Method:157 patients scheduled surgery under general anesthesia from August 2017 to June 2018 were enrolled in this study,with the standard of ASA Ⅱto Ⅲ and 40 to 90 kg weight,Two groups were divided according to age: the experimental group was the elderly group(Group O,n=70)and the control group was the young group(Group Y,n=87),the elderly group(Group O)was aged 65 to 80 years,and the young group(Group Y)was aged 27 to 64 years.The two groups were injected with midazolam 0.05mg/kg,fentanyl 3.5ug /kg,Cis-atracurium 0.15mg/kg,and finally injected with etomidate at a constant rate of 1ml/s,according the BIS values to adjust the dosage of etomidate.If BIS values are less than 60,the injection of etomidate is stopped and the dosage is recorded.Respectively observation records of the two groups home time(T0),immediately when induction(T1),1 min before tracheal intubation(T2),immediately when tracheal intubation(T3),3 min after tracheal intubation(T4),5 min after tracheal intubation(T5),and at the beginning of the operation(T6)of systolic blood pressure(SBP),mean arterial pressure(MAP),heart rate(HR),BIS value and adverse reactions.Results:⑴The comparison of the basic information of the patients: there was no statistically significant difference in gender,height,weight,ASA grade and hypertension between the two groups(P>0.05);⑵ The induction dosage of etomidate: the average dosage of etomidate used in the elderly group was(0.19 ±0.04)mg/kg,and the average dosage of etomidate used in the young group was(0.22±0.05)mg/kg.The group O were significantly lower than that of group Y,with statistically significant difference(P<0.05);⑶The comparison of the BIS value of the patients during anesthesia induction: BIS at T2~T4 of the elderly group were significantly lower than that of the young group,with statistically significant difference(P<0.05);BIS at T0、T1、T5、T6 of two groups were no statistically significant difference(P>0.05);⑷ The comparison of hemodynamics of the patients during anesthesia induction: SBP at T0、T1 of two groups were no statistically significant difference(P>0.05).during the induction period(T2~T3)SBP of group O was significantly lower than that of group Y(P<0.05).After intubation(T4 and T5),SBP of group O was significantly higher than that of group Y(P<0.05),at the beginning of the operation(T6)SBP of group O was significantly higher than that of group Y(P<0.05);MAP at T0、T1of two groups were no statistically significant difference(P>0.05).during the induction period(T2~T3)MAP of group O was significantly lower than that of group Y(P<0.05).After intubation(T4 and T5),MAP of group O was significantly higher than that of group Y(P<0.05),at the beginning of the operation(T6)SBP of group O was significantly higher than that of group Y(P<0.05);HR at T0、T1of two groups were no statistically significant difference(P>0.05).during the induction period(T2~T3)HR of group O was significantly lower than that of group Y(P<0.05),HR at T4、T5、T6 of two groups were no statistically significant difference(P>0.05);Conclusion:(1)With low dosage(0.19±0.04)mg/kg of etomidate under BIS monitoring,the elderly patients can achieve satisfactory depth of sedation with relatively stable hemodynamics and low incidence of adverse reactions.The study may provide guidance for induction dosage of general anesthesia of elderly patients.(2)The usage of etomidate in young patients was more than that in elderly patients at bispectral index-guided induction of general anesthesia,but hemodynamic changes were relatively smaller than those in elderly patients. |
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