丙泊酚与依托咪酯靶控输注在支气管镜麻醉效果的比较  

Comparison of Bronchoscopy Anesthesia Effects of Target Controlled Infusion by Propofol or Etomidate

作　　者：梁幸甜[1] 李渭敏[1] 廖美娟[1] 杨承祥[1] 

机构地区：[1]广东省佛山市第一人民医院,528000

出　　处：《实用医学杂志》2013年第10期1600-1602,共3页The Journal of Practical Medicine

摘　　要：目的:比较丙泊酚与依托咪酯分别联合瑞芬太尼靶控输注行支气管镜检查的麻醉效果。方法 :选择ASAⅠ-Ⅱ级择期行支气管镜检查的患者60例,随机分为丙泊酚组(P组)和依托咪酯组(E组),每组30例。分别设置效应室浓度P组为丙泊酚4.0μg/mL+瑞芬太尼6.0 ng/mL诱导,E组为依托咪酯1.0μg/mL+瑞芬太尼6.0 ng/mL诱导。达靶浓度后入镜,并调整药物浓度以维持麻醉。记录患者吸氧前(T0)、诱导开始1 min(T1)、入镜即时(T2)、入镜后1 min(T3)、入镜后2 min(T4)、入镜后5 min(T5)及术毕(T6)的MAP、HR及SpO2数据,记录检查时间、入睡时间、苏醒时间及麻醉期间不良事件例数并作统计学分析。结果:与P组比较,E组的苏醒时间延长;E组在T2时点MAP值较高,低血压发生率较低,注射痛发生率较低,而恶心、呕吐发生率较高。结论:丙泊酚与依托咪酯分别联合瑞芬太尼靶控输注用于支气管镜麻醉时,选择依托咪酯诱导使患者血压更平稳,但恶心、呕吐发生率高。选择丙泊酚诱导效果更满意。Objective To compare the effects of propofol or etomidate combining remifentanil target controlled infusion in bronchoscopy anesthesia.Methods 60 patients（ASA Ⅰ-Ⅱ grade）selectively undergoing bronchoscopy were randomly divided into propofol group（group P） and etomidate group（group E）（30 in each group）.Group P received 4.0 μg.ml-1 propofol and 6.0 ng.ml-1 remifentanil and group E received 1.0 μg.ml-1 etomidate and 6.0 ng.ml-1 remifentanil as induction.Bronchoscope was inserted when the above medicine was adjusted at target concentration.MAP,HR and SpO2 before oxygen uptaking（T0）,reduction starting 1 min（T1）,bronchoscope inserting（T2）,1 min post-inserting（T3）,2 min post-inserting（T4）,5min post-inserting（T5） and operation end.（T6）.Detecting time,sleeping time,and the adverse events during anesthesia period were recorded.Results Revival time in group E prolong than group P.At T2 in group E,MAP was higher,hypotension rate and pain rate lower,while rates of nausea and vomiting higher.Conclusion Etomidate combining remifentanil target controlled infusion in bronchoscopy anesthesia is able to obtain more steady blood pressure but higher rate of nausea and vomiting compared with propofol.While propofol reduction was much more satisfied.

关 键 词：丙泊酚 依托咪酯 靶控输注 支气管镜检查 

分 类 号：R614[医药卫生—麻醉学]