丙泊酚分次给药对老年患者麻醉诱导期血流动力学的影响  

Effect of propofol administration in divided doses on hemodynamics during general anesthesia induction in elderly patients

作　　者：王珊珊[1] 杜娟[1] 徐凯[1] 蒋玲[1] 赵卫兵[1] 

机构地区：[1]淮安市淮阴医院麻醉科,江苏淮安223300

出　　处：《新乡医学院学报》2015年第11期1009-1011,共3页Journal of Xinxiang Medical University

摘　　要：目的探讨丙泊酚分次给药对老年患者全身麻醉诱导期血流动力学的影响。方法老年择期手术患者60例,随机分为观察组和对照组,每组30例。对照组患者丙泊酚采用单次给药,静脉滴注,剂量为2 mg·kg-1;观察组患者丙泊酚分2次给药（总剂量仍为2 mg·kg-1）,先静脉滴注1.0 mg·kg-1,在插管前即刻再静脉滴注1.0 mg·kg-1。观察2组患者进入手术室后安静10 min时（T0）、麻醉诱导后（T1）、气管插管后1（T2）、3（T3）、5 min（T4）心率（HR）、平均动脉压（MAP）和脑电双频指数（BIS）的变化以及心血管不良事件、插管知晓的发生情况。结果2组患者T1时HR、MAP均较T0时明显降低,对照组患者T2、T3时HR、MAP较T0时明显升高（P〈0.05）。观察组患者T1时HR、MAP明显高于对照组（P〈0.05）,而T2、T3时HR、MAP明显低于对照组（P〈0.05）;2组患者T1~T4时BIS均明显低于T0（P〈0.05）;2组患者T1~T4时BIS及插管知晓发生率比较差异均无统计学意义（P〉0.05）;观察组患者心血管不良反应发生率明显低于对照组（P〈0.05）。结论老年患者全身麻醉诱导时采用丙泊酚分次给药,既能提供合适的麻醉深度,又可避免血流动力学的剧烈波动。Objective To observe the effect of propofol administration in divided doses on hemodynamics during general anesthesia induction in elderly patients. Methods Sixty patients undergoing elective surgery under general anesthesia were randomly divided into investigation group and control group,with 30 cases in each group. Anesthesia was induced with the same total dose of propofol in single dose 2. 0 mg · kg- 1in control group and in divided doses of 1. 0 mg · kg- 1and1. 0 mg·kg- 1in investigate group. The changes of heart rate（ HR）,mean arterial pressure（ MAR）,bispectral index（ BIS） at10 min after entering into operating room（ T0）,after anesthesia induction（ T1）,1,3,5 min after trachea cannula（ T2,T3,T4）,the incidences of cardiovascular adverse reactions and awareness of intubation were recorded and compared. Results MAP and HR in the two groups at T1 were lower significantly than those at T0（ P〈0. 05）. MAP and HR at T2 and T3in control group were higher significantly than those at T0（ P〈0. 05）. MAP and HR in investigation group were significantly higher at T1 while they were lower at T2 and T3than those in control group（ P〈0. 05）. BIS in the two groups at T1- T4 was significantly lower than that at T0（ P〈0. 05）. There was no significant difference in BIS at T1- T4 and awareness of intubation between the two groups. The incidence of cardiovascular adverse reactions in observation group was significantly lower than that in control group（ P〈0. 05）. Conclusion Propofol administration in divided doses not only provides appropriate depth of anesthesia,but also offers more stable hemodynamics for elderly patients.

关 键 词：丙泊酚 老年人 血流动力学 

分 类 号：R971[医药卫生—药品]