依托咪酯和丙泊酚在良性乳腺肿瘤手术中的应用  

Application of etomidate and propofol infusion in benign breast tumors operation

作　　者：迟猛[1] 李世杰[2] 张沛重 王国年[1] 

机构地区：[1]哈尔滨医科大学附属第三医院麻醉科,哈尔滨150081 [2]华北油田公司总医院性病科 [3]南阳医专一附院麻醉科

出　　处：《实用肿瘤学杂志》2012年第3期256-258,共3页Practical Oncology Journal

摘　　要：目的探讨依托咪酯和丙泊酚在良性乳腺肿瘤手术中的应用。方法 选择60例良性乳腺肿瘤手术患者，随机分为2组，每组30例（n=30），分别为依托咪酯组（E组），丙泊酚组（P组），两组均静注咪达唑仑2mg-3mg，E组患者静脉靶控输注依托咪酯，设定的效应室浓度为0．3μg／mL；P组患者静脉靶控输注异丙酚，设定效应室浓度为3μg／mL，两组在输注依托咪酯或丙泊酚同时靶控输注舒芬太尼0．1ng／mL。观察并记录患者术中血流动力学变化，呼吸抑制、肌震颤及术后恶心呕吐情况。结果与P组相比，E组的血流动力学变化明显平稳（P〈0．05）；呼吸抑制情况明显减轻（P〈0．05）；两组病人肌震颤情况无统计学差异（P〉0．05）；E组恶心呕吐发生率较P组高（P〈0．05）。结论靶控输注依托咪酯或异丙酚均可安全应用于乳腺良性肿瘤麻醉，依托咪酯对血流动力学及呼吸的影响较丙泊酚小，但其术后恶心呕吐的发生率较高。Objective To explore the efficacy and side effect of target controlled infusion （TCI）of etomidate in benign breast tumors operation. Methods Sixty patients undergoing benign breast tumors operation were randomly divided into two groups （ n = 30 ） ： etomidate group （ group E ） , etomidate were given by TCI targeting effect - site （ 0. 3 μg/mL ） ; propofol group （ group P ） , propofol were given by TCI targeting effect - site （3 μg/mL）. The two groups were all given midazolam 2 - 3 mg, sufentanyl by TCI targeting effect - site （0.1 ng/mL）. The HR, ECG, SpO2 and MAP in two groups were continuously monitored during the study. Respiratory depression, myoclonus, post operation nausea and vomiting were recorded. Results Compared with group P, group E had more stabilized hemodynamics （ P 〈 0.05 ）, lower respiratory depression incidence （ P 〈 0.05 ） and higher sedation degree（ P 〈 0.05 ）. There was no significant difference in myoclonus between them,but the Group E has higner incidence than group P in post operation nausea and vomiting. Conclusion Both etomidate and propofol given by target controlled infusion can be safely used in benign breast tumors, but the etomidated group had more stabilized hemodynamics and lower respiratory depression incidence than propofol group. Besides, group E had higher incidence of Dostooerative nausea and vomiting.

关 键 词：依托咪酯 丙泊酚 乳腺良性肿瘤 靶控输注 

分 类 号：R739.9[医药卫生—肿瘤]