异丙酚分步效应室靶控输注用于全麻诱导的效果观察  

Effect of Propofol Stepwise Effect Chamber Target Controlled Infusion in General Anaesthesia Induction

作　　者：李钊[1,2] 赵砚丽[1] 李建立[1] 张煜东[1] 岳立辉[1] 

机构地区：[1]河北省人民医院麻醉科,河北省石家庄市050051 [2]冀中能源峰峰集团总医院

出　　处：《中国全科医学》2009年第18期1684-1686,共3页Chinese General Practice

摘　　要：目的评价异丙酚分步效应室TCI诱导模式在妇科腹腔镜手术患者全麻诱导中应用的效果。方法选择择期全麻下行妇科腹腔镜手术患者40例,随机分为常规效应室TCI诱导组(Ⅰ组)和分步效应室TCI诱导组(Ⅱ组)。分别记录两组患者麻醉诱导开始前(T0)、意识消失时(T1)、气管插管前即刻(T2)及气管插管完成时(T3)患者平均动脉压、心率及麻醉深度状态指数值。记录起效时间(开始输注异丙酚到意识消失时间),异丙酚血浆峰浓度,插管完成时间(开始输注异丙酚到气管插管完成时间),插管完成时异丙酚用量。结果两组患者不同时间点平均动脉压和心率间差异均有统计学意义(F值分别为30.82和25.69,P<0.05),与T0时比较两组患者平均动脉压均于T1时出现降低(P<0.05),T2时达最低值(P<0.05),T3时恢复至T0水平(P>0.05);T1、T2时间点组间比较显示Ⅰ组平均动脉压低于Ⅱ组(P<0.05)。与T0时比较两组患者心率均于T1时出现降低(P<0.05),T3时恢复T0水平(P>0.05)。与Ⅰ组比较,Ⅱ组起效时间、插管完成时间显著延长(P<0.05),异丙酚血浆峰浓度明显降低(P<0.05),但两组气管插管完成时异丙酚用量间差异无统计学意义(P>0.05)。结论异丙酚分步效应室TCI诱导模式对血流动力学的影响较轻,可安全有效地应用于全麻诱导。Objective To investigate the effect of stepwise effect chamber target - controlled infusion （TCI） during general anaesthesia induction. Methods Forty patients, who underwent gynecologic laparoscopic surgery in general anesthesia, were randomly allocated into group Ⅰ （routine effect chamber TCI induction group） and group Ⅱ （stepwise effect chamber TCI induction group）. Mean arterial pressure （MAP）, heart rate （HR） and depth of anesthesia index were recorded before induction （ T0 ）, during awareness disappearance （ T1 ）, just before tracheal intubation （ T2 ） and after （ T3 ）, respectively, in both groups. And Time of taking effect （ the time from propofol infusion to consciousness loss）, propofol peak serum concentration, time of intubation completion （ from the beginning of propofol infusion to intubation completion ） and the dosage of propofol during intubation were measured. Results There was significant difference in MAP and HR at different time points between 2 groups （ F = 30. 82, 25.69, respectively, P 〈 0. 05 ）. When compared with level at T0, MAP decreased at T1 （ P 〈 0.05 ）, and reached the nadir at T2 （P 〈 0.05）, and returned to T0 level at T3 （P 〉 0. 05 ） ; Comparison between groups T1 and T2 showed that MAP was lower in group Ⅰ than in group Ⅱ （ P 〈 0. 05 ）. As compared with To level, HR decreased at T1 （ P 〈 0.05 ）, and returned to To level at T3 in 2 groups （P 〉 0. 05）. When compared with group Ⅰ , time of taking effect and of intubation was significantly prolonged （ P 〈 0. 05 ） and propofol peak serum concentration reduced in group Ⅱ （ P 〈 0. 05 ）, but there was not significant difference in propofol dosage during intubation between 2 groups （ P 〉 0. 05 ）. Conclusion Stepwise induction of effect chamber TCI, having less effect on hemodynamics, can be used safely and effectively in general anesthesia induction.

关 键 词：二异丙酚 麻醉 全身 药物投与系统 脑电描记术 

分 类 号：R971.2[医药卫生—药品]