卵巢周期对患者异丙酚镇静效应的影响  

Effect of ovarian cycle on sedative effect of propofol

作　　者：陆斌[1] 吴安生[1] 张序忠[1] 李军[2] 

机构地区：[1]温州医学院附属第三医院麻醉科,325200 [2]温州医学院附属第二医院麻醉科

出　　处：《中华麻醉学杂志》2011年第5期544-546,共3页Chinese Journal of Anesthesiology

摘　　要：目的 评价卵巢周期对患者异丙酚镇静效应的影响。方法择期拟行妇科腹腔镜手术患者40例，ASA分级Ⅰ或Ⅱ级，年龄20～40岁，体重指数20～25kg／m^2，根据孕酮水平分为卵泡期组（F组，血清孕酮浓度0．31～1．52ng／ml）和黄体期组（L组，血清孕酮浓度5．16～18．56ng／ml），每组20例。麻醉诱导时靶控输注异丙酚，初始血浆靶浓度2μg／ml，达到预期血浆靶浓度后每隔30S递增0．5μg／ml直至患者意识消失及BIS值降至50。记录患者意识消失时的BIS值、异丙酚血浆靶浓度，记录BIS值降至50时的异丙酚血浆靶浓度。结果与L组比较，F组意识消失时和BIS值降至50时的异丙酚血浆靶浓度升高（P〈0．05或0．01），意识消失时的BIS值差异无统计学意义（P〉0．05）。结论卵巢周期可影响异丙酚的镇静效应，表现为卵泡期的镇静效应低于黄体期。Objective To investigate the effect of ovarian cycle on the sedative effect of propofol in patients. Methods Forty ASA Ⅰ or Ⅱ patients, aged 20-40 yr, with body mass index 20-25 kg/m2 , scheduled for elective gynecologic laparoscopic surgery, were divided into 2 groups according to the progesterone level （ n = 20 each）： follicular phase group （group F, serum progesterone concentration 0.31-1.52 ng/ml） and luteal phase group （group L, serum progesterone concentration 5.16-18.56 ng/ml）. Anesthesia was induced with target-controlled infusion （TCI） of propofol and iv injection of fentanyl and cisatracurium. The initial target plasma concen- tration （Cp） of propofol was set at 2μg/ml, after the Cp reached the predetermined level, the Cp increased by 0.5 μg/ml every 30 s until the patients lost consciousness and BIS value was decreased to 50. The BIS value and Cp of prupofol was recorded when the patients lost consciousness. The Cp of propofol was also recorded when BIS value was decreased to 50. The patients were tracheal intubated and mechanically ventilated. Anesthesia was maintained with TCI of propofol combined with remifentanil. BIS value was maintained at 45-55 by adjusting the Cp of propo- fol. Results The Cps of propofol were significantly higher when the patients lost consciousness and when BIS value was decreased to 50 in group F than in group L （P 〈 0.05 or 0.01）. There was no significant difference in BIS value when the patients lost consciousness between the two groups （ P 〉 0.05）. Conclusion Ovarian cycle can affect the sedative effect of propofol in patients, which shows that the sedative effect during the follicular phase is lower than that during the luteal phase.

关 键 词：月经周期 二异丙酚 清醒镇静 

分 类 号：R614[医药卫生—麻醉学]