靶控输注丙泊酚在高海拔与低海拔的比较  

Comparison of propofol by target-controlled influsion at high altitude and low altitude

作　　者：祁延杰 杨晓黎 林元 龙勤[2] 蒋燕[2] 沈茜[2] 雷晓峰[2] 

机构地区：[1]昌都市人民医院麻醉科,西藏昌都854000 [2]重庆市肿瘤研究所麻醉科,重庆400030

出　　处：《中国新药与临床杂志》2017年第8期474-476,共3页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的评价靶控输注丙泊酚在高海拔的麻醉效果。方法择期下肢手术患者138例,ASAⅠ~Ⅱ级,均采用气管内插管全麻。高海拔组69例,来自昌都市(海拔3 200 m),低海拔组69例,来自重庆市(海拔250 m)。两组麻醉诱导均予靶控输注丙泊酚3.0μg·m L-1,后每2 min增加0.5μg·m L-1,至脑电双频指数(BIS)值达50,调节丙泊酚的靶控输注浓度维持BIS值40~60。观察麻醉诱导时间、丙泊酚的麻醉诱导剂量和总用量,记录给药前(T0)、插管前(T1)、插管后1 min(T2)、切皮时(T3)和拔管时(T4)五个时点患者的心率(HR)和平均动脉压(MAP)。结果高海拔组麻醉诱导时间为(208±25)s,长于对照组[(155±29)s,P<0.05]。高海拔组丙泊酚麻醉诱导剂量和总用量分别为(142±13)mg和(678±39)mg,均高于低海拔组[(110±14)mg和(585±35)mg,P<0.05]。与T0时相比,两组T1时HR和MAP均降低;各观察时点,高海拔组HR低于低海拔组,MAP高于低海拔组(P<0.05)。结论靶控输注丙泊酚在高海拔是安全可行的,围术期全麻所需静脉麻醉药剂量高于低海拔地区。AIM To evaluate the anesthetic effects high altitude （HA） and low altitude （LA）. METHODS of propofol by target-controlled infusion （TCI） at One hundred and thirty eight ASA Ⅰ - Ⅱ patients scheduled for elective lower extremity surgery were enrolled. There were 69 patients in HA group （Changdu, 3 200 m above the sea level） and 69 patients in LA group （Chongqing, 250 m above the sea level）. Propofol of two groups was administered by TCI at a target blood concentration from 3 μg·mL-1 during induction of anesthesia, then the target concentration was increased 0.5 μg·mL-1 each 2 min to achieve a target bispectral index （BIS） of 50. A target BIS of 40-60 was maintained through adjusting concentration of propofol by TCI of two groups during maintenance of anesthesia. The induction times of two groups were observed, and the induction dosage and the total amount of propofol were counted. Heart rate （HR） and mean arterial pressure （MAP） at pre-administration （To）, pre-tracheal intubation （TI）, 1 rain after intubation （T2）, incision （T3） and extubation （T4） were recorded. RESULTS The induction time of the HA group was （208 ± 25） s, which was significantly longer than that of the LA group （ （ 155 ±29） s, P 〈 0.05）. The induction dosage and the total amount of propofol of the HA group were （142 ± 13） mg and （678 ± 39） rag, which were higher than those of the LA group （（110 ± 14） mg and （585 ±35） mg, P 〈 0.05）. Compared with those at To, HR and MAP at T1 were lower in both groups （P 〈 0.05）. HR of the HA group was significantly lower than that of the LA group at each observation point （P 〈 0.05）, while MAP of the HA group was significantly higher （P 〈 0.05）. CONCLUSION Propofol by TCI at HA ansethesia may be required at HA compared to LA is effective, and more intravenous anesthetics for general during perioperative period

关 键 词：丙泊酚 麻醉 高海拔 靶控输注 

分 类 号：R614[医药卫生—麻醉学] R971[医药卫生—外科学]