丙泊酚靶控输注麻醉维持对老年胃癌根治术患者血流动力学及苏醒质量的影响  

Influence on Hemodynamic Changes and Awake State by Propofol Target-Controlled Infusion for Anesthesia Maintained in Elderly Patients with Radical Gastrectomy

作　　者：吴明毅[1] 孙玉明[1] 褚文彦[1] 李江伟[1] 刘冰[1] 王云[1] 邢翠燕[2] 

机构地区：[1]武警山东总队医院麻醉科,山东济南250014 [2]山东省立医院麻醉科,山东济南250021

出　　处：《现代生物医学进展》2012年第33期6549-6551,6590,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨丙泊酚靶控输注麻醉维持对老年胃癌根治术患者血流动力学以及术后苏醒质量的影响。方法:ASAI～Ⅱ级行胃癌根治术的60例患者随机分为A组和B组。两组使用靶控输注麻醉诱导,起始血浆靶浓度为1μg·ml-11%丙泊酚泵注,A组采用靶控输注丙泊酚维持麻醉,B组采用七氟烷吸入维持麻醉。记录麻醉前(T0)、切皮后5min(T1)、手术开始30 min(T2)、手术开始60min(T3)、停药时(T4)、出室时(T5)各时间点的血流动力学指标的变化。记录患者术后睁眼时间、拔管时间、定向力恢复时间。结果:两组血流动力学指标(SBP、DBP、HR)在T1～T3时点迅速下降,与T0比较均有显著性差异(P<0.05),T4时血流动力学指标(SBP、DBP、HR)开始上升,至T5时基本达到基线水平,与T0比较差异无统计学意义(P>0.05)。血流动力学指标(SBP、DBP、HR)在组间比较差异均无统计学意义(P>0.05)。两组术后睁眼时间比较差异无统计学意义(P>0.05),A组术后拔管时间、定向力恢复时间均低于B组,相比较有显著性差异(P<0.05)。结论:丙泊酚靶控输注麻醉维持对老年胃癌根治术患者血流动力学影响小,患者术后苏醒质量高,是老年胃癌根治术患者理想的麻醉方法。Objective： To investigate the influence on hemodynamie changes and awake state by propofol target-controlled infusion for anesthesia maintained in elderly patients with radical gastrectomy. Methods： 60 elderly patients with radical gastrectomy of ASA I - II were randomly divided into A group and B group. The two groups was given the anesthesia inducted of initial target plasma concentration of 1 μg· ml^-1 1% propofol by TCI. The A group was given propofol target-controlled infusion for anesthesia maintained, and the B group was given sevoflurane for anesthesia maintained. The hemodynamic changes were recorded before anesthesia （TO）, after incision 5min （T1）, beginning of surgery 30min （T2）, beginning of surgery 60min （T3）, withdrawal （T4） and leaving the operating room （T5）, the eye opening, extubation time and recovery time of orientation were recorded. Results： Compared with the value of hemodynamic at TO, the SBP, DBP and HR were significantly decreased at T1 - T3, the difference was significant （P 〈0.05）; The hemodynamic index （SBP, DBP and HR） increased at T4, basically reached the baseline level at T5, compared with the value of hemodynamics at TO the difference was no significant （P〉 0.05）. The eye opening of the two group was no significant （P〉 0.05）, the extubation time and recovery time of orientation of the A group were lower than the group B, and the difference between them was significant （P 〈0.05）. Conclusion： The propofol target-controlled infusion for anesthesia maintained can reduce the impact on hemodynamics in elderly patients with radical gastrectomy, the patients has high-quality postoperative recovery. It is an ideal method of anesthesia maintained for elderly patients with radical gastrectomy.

关 键 词：丙泊酚 血液流变学 苏醒质量 胃癌根治术 靶控输注技术 

分 类 号：R614[医药卫生—麻醉学] R735.2[医药卫生—外科学]