单次静脉注射小剂量普鲁泊福对围拔管期患者应激反应影响的临床观察  

Effect of single and low dose propofol intravenously on cardiovascular and adverse response during extubation in patients undergoing ovarian cancer operation

作　　者：杨帆[1] 郭瑶[1] 孟凌新[1] 

机构地区：[1]中国医科大学附属盛京医院麻醉科,沈阳110004

出　　处：《中国医师进修杂志》2010年第3期21-23,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的观察拔管前单次静脉注射小剂量普鲁泊福对围拔管期患者的应激反应及苏醒情况的影响。方法选择ASA分级Ⅰ～Ⅱ级，拟于全麻下择期行卵巢癌手术的患者50例，按照随机数字表法随机分为七氟烷组（s组）和普鲁泊福组（P组），每组各25例。s组在预计手术结束前2min停止吸入七氟烷。P组在预计手术结束前5min停止吸入七氟烷，同时静脉单次推注普鲁泊福0．5mg／kg。观察两组患者拔管前5min、拔管时、拔管后1min、拔管后5min的收缩压、舒张压、心率，以及患者意识恢复时间，躁动、剧烈呛咳及恶心呕吐的情况。结果两组在拔管时至拔管后5min心率、收缩压、舒张压比较差异均有统计学意义（P〈0．01）。P组意识恢复时间[（10．39±1．26）min]与s组[（9．57±1．25）min]比较差异有统计学意义（P〈0．05），但是并不显著延长拔管时间。P组2例发生躁动，s组9例发生躁动，两组比较差异有统计学意义（P〈0．05）。结论拔管前单次静脉注射小剂量普鲁泊福可减小围拔管期患者的应激反应，且患者意识恢复良好，不良反应发生率低。Objective To observe the effect of single and low dose propofol administered near the end of surgery on the cardiovascular and adverse response during extubation in patients undergoing ovarian cancer operation. Methods Fifty ASA Ⅰ～Ⅱ patients undergoing selective ovarian cancer operation were randomly allocated into group S and group P,with 25 patients in each group. In group S, inhalation of sevoflurane was discontinued at about 2 minutes before the end of operation. In group P, inhalation of sevoflurane was discontinued at about 5 minutes before the end of operation, and at the same time, 0.5 mg/kg of propofol was administered intravenously. The systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR） and recovery time of consciousness were recorded at 5 min before extubation （t1）, during extubation （t2）, 1 rain after extubation （t3）, and 5 min after extubation （t4）. The incidence of agitation,bucking, nausea and vomiting were recorded by an observer who was blind to this study. Results There were statistical differences in HR,SBP,DBP at t2-t4 between two groups. The recovery time was （ 10.39 ± 1.26） min in group P, and（9.57 ± 1.25 ） rain in group S, there was significant difference between group P （2 cases ） and group S （9 cases）（P 〈 0.05 ）. There was significant difference in the incidence of agitation between two groups （P 〈 0.05 ）. Conclusion Low dose propofol before extubation can inhibit stress and cardiovascular response and decrease the incidence of agitation, bucking, nausea and vomiting.

关 键 词：二异丙酚 麻醉 全身 应激 气管拔管 

分 类 号：R971.8[医药卫生—药品] R169.42[医药卫生—药学]