BIS监测为导向的丙泊酚靶控输注预防卡前列素氨丁三醇不良反应的前瞻性、随机对照研究  

The effect of BIS-guided propofol TCI in preventing adverse effect of carboprost tromethamine in puerperants undergoing caesarean section: a prospective, randomized controlled trial

作　　者：张鹏[1] 庄菁 李耀[1] 

机构地区：[1]电子科技大学附属医院.四川省人民医院麻醉科,成都610072

出　　处：《实用医学杂志》2018年第1期124-127,共4页The Journal of Practical Medicine

基　　金：四川省卫生和计划生育委员会科研课题(普及应用项目)(编号:17PJ223)

摘　　要：目的丙泊酚靶控输注并以BIS监测为导向,调整靶控浓度达到预设镇静深度,能否预防剖宫产术中卡前列素氨丁三醇的不良反应。方法将354例腰硬联合麻醉下行择期剖宫产的产妇随机分成3组。胎儿娩出后:(1)对照组持续泵注10 m L/h生理盐水;(2)BIS 85组,丙泊酚靶控输注以0.8μg/m L为起始,调整浓度维持术中BIS 80~90;(3)BIS 75组,丙泊酚靶控输注以1.2μg/m L为起始,调整浓度维持术中BIS 70~80,均至手术结束。比较3组产妇恶心、呕吐、腹泻、胸闷和头痛的发生率。结果与对照组相比,丙泊酚BIS 85组仅能减少胸闷的发生率,差异有统计学意义(P=0.004)。与对照组相比,BIS 75组能减少产妇恶心、呕吐以及胸闷的发生率,差异均有统计学意义(三者均P<0.001)。BIS 85组和BIS 75组的产妇术中均未出现头痛。结论腰硬联合麻醉下,术中丙泊酚靶控输注维持BIS 70~80之间,能有效预防剖宫产产妇卡前列素氨丁三醇的不良反应的发生。Objective To investigate whether BIS-guided （target-controlled infusion） propofol TCI can ef- fectively prevent adverse effects of carboprost tromethamine in patients undergoing caesarean section. Methods Three hundred and fifty-four puerperants underwent spinal-epidural anesthesia were randomized into 3 groups： after fetal childbirth, in the control group, normal saline was infused at a rate of 10 ml/h. BIS 85 group, propofol with the initial target plasma concentrations of 0.8 μg/ml by TCI, adjusted TCI concentration and maintained BIS 80-90. BIS 75 group, propofol with the initial target plasma concentrations of 1.2 μg/ml by TCI, adjusted TCI concentration and maintained BIS 70-80, both until the end of operation, tThe rate of nausea, vomiting, diarrhea,chest congestion and headache were compared among 3 groups. Results Compared with the control group, the incidence of chest congestion was significantly reduced in BIS 85 group （P = 0.004）. The incidence of nausea, vomiting and chest congestion were significantly reduced in BIS 75 group （P 〈 0.001, respectively）. The puerperants in 2 BIS groups had no complaints of headache. Conclusion BIS-guided propofol TCI and maintaining BIS 70-80 can effectively prevent adverse effect of carboprost tromethamine in puerperants undergoing spinal-epidural anesthesia in caesarean section

关 键 词：丙泊酚 靶控输注 卡前列素氨丁三醇 剖宫产 

分 类 号：R614[医药卫生—麻醉学]