Application value of lobeline in intravenous anesthesia of elderly patients undergoing endoscopic surgery

doi:10.3877/cma.j.issn.2095-8757.2021.01.007

Abstract

Abstract:

Objective

To observe the application value of lobelin in the elderly patients with endoscopic surgery under intravenous anesthesia.

Methods

300 elderly patients who received intravenous anesthesia for endoscopic surgery in Xiaogan First People's Hospital from February 2020 to February 2021 were selected. Among them, 150 cases (control group) were given intravenous anesthesia with dezocine 0.05 mg/kg + propofol 1.5 mg/kg, and the other 150 cases (observation group) were given intravenous anesthesia with dezocine 0.05 mg/kg + lobeline 3.0 mg + propofol 1.5 mg/kg. The bispectral index (BIS) was controlled in 50-60 for operation and maintenance.. During the operation, 0.5 mg/kg of propofol was added intermittently single time according to the operation progress. The mean arterial pressure (MAP), heart rate, pulse oxygen saturation (SpO₂), pulse oxygen saturation (PetCO₂), BIS, apnea, hypoxemia, the incidence of postoperative awake time, recovery time and recovery delay rate were observed at 1 min (T₁), 3 min (T₂), 5 min (T₃), 10 min (T₄), and 15 min (T₅) after starting anesthesia in two groups. T test was used to compare the independent measurement data between the two groups, repeated measurement analysis of variance was used to compare the continuous measurement data, and χ² test was used to compare the counting data.

Results

There were significant differences in SpO₂ and PetCO₂ between the two groups after anesthesia (F=13.620, 19.250, P < 0.05), and the SpO₂ and PetCO₂ in the observation group were significantly higher than those in the control group at T₁, T₂, T₃, T₄ and T₅ (P < 0.05). There was no significant difference in MAP, heart rate and BIS between the two groups (F=3.521, 1.521, P < 0.05). There were no significant difference in awake time, time out of recovery room and incidence of delayed recovery between the two groups (t=0.181, 0.082, χ²=0.000, P > 0.05), the incidence of apnea and hypoxemia in the observation group was significantly lower than that in the control group, the difference was statistically significant (χ²=31.274, 33.166, P > 0.05).

Conclusion

For elderly patients with endoscopic surgery, the prophylactic use of lobeline in intravenous anesthesia is safe and effective, which can significantly reduce the incidence of hypoxemia in elderly patients, and does not prolong the postoperative recovery and out of room time.

Key words: Lobarin, Elderly patients, Endoscopic surgery, Intravenous anesthesia, Hypoxemia, Application value

Zefan Hu, Zhongcheng Hu, Jian Ma, Dingxiong Yue, Kai Zhang, Lin Li. Application value of lobeline in intravenous anesthesia of elderly patients undergoing endoscopic surgery[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2021, 08(01): 28-33.

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References 35

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指标	观察组（n=150）	对照组（n=150）	检验值	P值
年龄（岁）	65～75（69.6±10.0）	65～75（68.9±11.9）	t=1.701	>0.05
性别（男/女，例）	76/74	78/72	χ²=0.053	>0.05
体质量（kg）	45～70（62.3±4.2）	46～70（61.8±6.7）	t=0.952	>0.05
BMI（kg/m²）	16～29（18.2+2.5）	16～29（18.3+2.3）	t=0.562	>0.05
ASA分级（Ⅱ/Ⅲ，例）	98/52	100/50	χ²=0.059	>0.05
手术时间（min）	15～25（17.2±6.9）	15～26（15.3±6.7）	t=0.251	>0.05
术式（例）			χ²=0.000	>0.05
胃镜治疗（例）	40	40
肠镜治疗（例）	40	40
ERCP治疗（例）	20	20
膀胱镜治疗（例）	20	20
输尿管镜取石术（例）	30	30

指标	观察组（n=150）	对照组（n=150）	检验值	P值
年龄（岁）	65～75（69.6±10.0）	65～75（68.9±11.9）	t=1.701	>0.05
性别（男/女，例）	76/74	78/72	χ²=0.053	>0.05
体质量（kg）	45～70（62.3±4.2）	46～70（61.8±6.7）	t=0.952	>0.05
BMI（kg/m²）	16～29（18.2+2.5）	16～29（18.3+2.3）	t=0.562	>0.05
ASA分级（Ⅱ/Ⅲ，例）	98/52	100/50	χ²=0.059	>0.05
手术时间（min）	15～25（17.2±6.9）	15～26（15.3±6.7）	t=0.251	>0.05
术式（例）			χ²=0.000	>0.05
胃镜治疗（例）	40	40
肠镜治疗（例）	40	40
ERCP治疗（例）	20	20
膀胱镜治疗（例）	20	20
输尿管镜取石术（例）	30	30

指标		观察组（n=50）	对照组（n=50）
SpO₂（%）
	T₁	96.87±1.19	90.27±2.23
	T₂	97.07±1.09	92.87±1.59
	T₃	98.22±1.02	93.11±1.15
	T₄	97.58±1.02	94.12±1.55
	T₅	98.18±1.12	95.18±1.22
PETCO₂（mmHg）
	T₁	37.39±2.04	28.39±1.76
	T₂	38.53±1.89	30.54±1.67
	T₃	38.89±2.41	31.62±2.01
	T₄	39.22±3.13	34.88±5.02
	T₅	40.14±2.58	35.06±4.12

指标		观察组（n=50）	对照组（n=50）
SpO₂（%）
	T₁	96.87±1.19	90.27±2.23
	T₂	97.07±1.09	92.87±1.59
	T₃	98.22±1.02	93.11±1.15
	T₄	97.58±1.02	94.12±1.55
	T₅	98.18±1.12	95.18±1.22
PETCO₂（mmHg）
	T₁	37.39±2.04	28.39±1.76
	T₂	38.53±1.89	30.54±1.67
	T₃	38.89±2.41	31.62±2.01
	T₄	39.22±3.13	34.88±5.02
	T₅	40.14±2.58	35.06±4.12

指标		观察组（n=50）	对照组（n=50）
MAP（mmHg）
	T₁	63.52±3.41	62.65±6.56
	T₂	65.55±3.43	65.52±5.32
	T₃	69.52±3.41	68.52±5.31
	T₄	70.52±3.41	71.52±4.42
	T₅	76.52±3.41	77.31±4.33
心率（次/min）
	T₁	66.22±7.04	65.49±4.43
	T₂	63.42±3.41	63.52±4.42
	T₃	69.32±4.42	68.47±3.85
	T₄	70.55±4.51	70.52±3.48
	T₅	71.52±3.43	71.12±3.11
BIS
	T₁	52.21±3.34	52.11±3.14
	T₂	54.21±3.24	54.55±3.44
	T₃	54.41±4.14	55.11±3.84
	T₄	55.21±2.54	55.31±3.14
	T₅	58.21±4.33	57.51±4.53

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