目的 探讨老年腹腔镜手术患者采用依托咪酯复合瑞芬太尼麻醉诱导对其应激指标的影响。方法 选取2016年7月—2018年7月拟行腹腔镜手术的老年患者72例,根据随机数表法分为对照组(n=36)和观察组(n=36)。对照组采用丙泊酚复合瑞芬太尼麻醉诱导,观察组采用依托咪酯复合瑞芬太尼麻醉诱导,对比两组皮质醇浓度及简易智力状态检查量表(MMSE)评分。结果 观察组插管前、气管插管后即刻、气管插管后3 min及气管插管后5 min时患者皮质醇浓度低于对照组,差异有统计学意义(P＜0.05)。相较于对照组,观察组术后24 hMMSE评分较高,差异有统计学意义(P＜0.05)。结论 在减轻老年腹腔镜手术患者应激反应方面,依托咪酯复合瑞芬太尼麻醉诱导具有较好的效果,可能参与了对认知功能下降的减缓作用。

Objective To investigate the effect of etomidate combined with remifentanil anesthesia induction on stress indicators in senile patients with laparoscopic surgery.Methods A total of 72 senile patients with laparoscopic surgery from July 2016 to July 2018 were selected and divided into control group (n=36) and observation group (n=36) by random number table.The control group was given propofol combined with remifentanil anesthesia induction, while the observation group was given etomidate combined with remifentanil anesthesia induction.The concentration of cortisol and the score of Mini-Mental State Examination (MMSE) were compared between the two groups.Results Before intubation, after intubation, 3 min after intubation, and 5 min after intubation, the concentrations of cortisol in the observation group were lower than these in the control group (P<0.05).The postoperative 24 h MMSE score of the observation group was higher than that of the control group (P<0.05).Conclusion Etomidate combined with remifentanil anesthesia induction for senile patients with laparoscopic surgery has better effect of relieving stress response which may be involved in the decline of cognitive function.