靶控输注异丙酚在妇科腹腔镜手术中的应用  

The propofol which is injected by the target controlled infusion system used in laparoscope operation of gynecology

作　　者：王长社[1] 李胜华[1] 

机构地区：[1]上海市嘉定区妇幼保健院麻醉科,上海201800

出　　处：《徐州医学院学报》2013年第1期40-41,共2页Acta Academiae Medicinae Xuzhou

摘　　要：目的观察靶控输注（TCI）异丙酚在妇科腹腔镜手术中应用的可行性。方法选择ASAI～Ⅱ级妇科择期腹腔镜手术患者60例，随机分为2组（n=30）。TCI组采用异丙酚TCI3mg／L，对照组静脉输注异丙酚1．5mg／kg，咪达唑仑0．04mg／kg、芬太尼0．003mg／kg、万可松0．1mg／kg诱导。术中吸入2％异氟醚，TCI组给予异丙酚1mg／L，对照组异丙酚3mg·kg·h-1，间断给予芬太尼和万可松维持麻醉。记录麻醉前（T0）、气管插管时（T1）、插管后即刻（T2）、插管后5min（T3）、手术结束前10min（T4）2组的平均动脉压（MAP）、心率（HR）和停止输注异丙酚至患者苏醒时间、手术时间和异丙酚的用量。结果T2时2组MAP均明显升高（P〈0．05），T2时TCI组MAP较对照组低（P〈0．05）；与T1时比较，T2时2组HR增快（P〈0．05）；TCI组异丙酚用量比对照组减少，苏醒时间比对照组缩短（P〈0．05或P〈0．01）。结论异丙酚TCI麻醉用于妇科腹腔镜手术能够较好地减轻插管反应、减少异丙酚用量、缩短苏醒时间，值得临床推广。Objective To investigate the feasibility of the propofol which is injected by the target controlled infusion （TCI） system used in laparoscope operation of gynecology. Methods Sixty patients （ASA I - Ⅱ） undergoing laparo- scope operation of gynecology were randomly assigned to two groups （ n = 30 ）. All patients received general anesthesia, they were induced by midazolam 0.04 mg·kg-1, fentanyl 0. 003 mg·kg-1, veeuronium 0.1 mg· kg-1. Anesthesia was maintained with 2% isoflurane inhalation, continuous infusion propofol of 1 mg/L （group I ） or 3 mg· kg-1· h-1 （group Ⅱ ） and inject fentanyl and vecuronium. The mean arterial blood pressure （MAP） and heart rate （HR） before anesthesia （ TO ）, during intubation （ T1 ）, immediately after intubation （ T2 ）, 5 minutes （ T3 ） after, 10 minutes before the end of the operation （ T4 ）. And record the operation time, the total quantity of propofol and the time from stopg injec- ting the propofol to the patient awake. Results MAP was higher at T2 than T1 （ P 〈 0.05 ） and it was lower in group I than that in group Ⅱ at T2 （ P 〈 0.05 ）. HR was faster in two groups at T2 than T1 （ P 〈 0.05 ）. The operation time had no statistical difference in two groups （ P 〉 0.05 ）. The total quantity of propofol used in group I was fewer than that in group Ⅱ （ P 〈 0.05 ）. The awekening time was longer in group Ⅱthan that in group I （ P 〈 0.01 ）. Conclusion The propofol which is injected by TCI system used in laparoscope operation of gynecology, it can alleviate the patients reaction at intubation and a shorter awakening time.

关 键 词：异丙酚 靶控输注 全身麻醉 插管反应 苏醒时间 

分 类 号：R614.2[医药卫生—麻醉学]