机器人腹腔镜下前列腺癌根治术中不同麻醉药物对患者眼内压和眼灌注压的影响  

Effects of Different Anesthetics on Intraocular Pressure and Intraocular Perfusion Pressure in Patients Undergoing Robo-laparoscopic Radical Prostatectomy for Prostate Cancer

作　　者：曾思[1] 徐广民[1] 苏文杰[1] 胡云霞[1] Zeng Si;Xu Guangmin;Su Wenjie;et al.(Department of Anesthe- siology, Sichuan Provincial Academy of Medical Sciences ~ Sichuan Provincial People＇s Hospital, Chengdu, Sichuan 610072, China)

机构地区：[1]四川省医学科学院.四川省人民医院麻醉科,四川成都610072

出　　处：《四川医学》2018年第3期296-298,共3页Sichuan Medical Journal

摘　　要：目的观察机器人腹腔镜辅助下前列腺癌根治术手术中不同麻醉药物对患者眼内压和眼灌注压的影响。方法择期行机器人腹腔镜下前列腺癌根治术的患者40例,随机分为全屏吸入组和全屏静脉麻醉组,两组分别采用七氟醚和异丙酚诱导和维持,分别于诱导前(T0)、插管后5min(T1)、Trendelenberg体位建立气腹30min(T2)、Trendelenberg体位建立气腹90min(T3)、停气腹平卧后15min(T4),手术结束60min(T5)。观察记录患者眼内压和眼灌注压的变化。结果分别采用七氟烷或异丙酚复合瑞芬太尼麻醉期间两组患者的平均动脉压(MAP)、潮气量(Tidal volume)、呼吸末二氧化碳(End-tidal CO2)、麻醉深度指数(CSI)无显著差异,在Trendelenberg体位和CO2气腹建立后七氟烷麻醉组IOP明显高于异丙酚麻醉组(P<0.05),OPP低于异丙酚麻醉(P<0.05)。结论机器人腹腔镜下前列腺癌根治术中采用异丙酚复合瑞芬太尼全身麻醉降低患者IOP的作用优于七氟醚复合瑞芬太尼复合麻醉。Objective To observe the effect of different anesthetics on intraocular pressure and intraocular perfusion pressure in patients with robo-laparoscopic radical prostatectomy for prostate cancer.Methods 40 patients undergoing robo-laparoscopic radical prostatectomy for prostate cancer were randomly divided into full screen inhalation group and full screen intravenous anesthesia group.Two groups were induced and maintained by sevoflurane and propofol,respectively.The changes of intraocular pressure and intraocular perfusion pressure were observed and recorded respectively at before induction（ T0） 、5 min after intubation（ T1） 、30 min after establishment of pneumoperitoneum in Trendelenberg position（ T2） 、90 min after establishment of pneumoperitoneum in Trendelenberg position（ T3） 、lying down for 15 min after stopping pneumoperitoneum（ T4） 、60 min after sungery. Results During anesthesia with sevoflurane or propofol combined with remifentanil,there was no significant difference in the mean arterial pressure（ MAP）,tidal volume（ Tidal volume）,end-respiratory carbon dioxide（ End-tidal CO2） and anesthesia depth index（ CSI） in both groups（ P〈0. 05）,and OPP was lower than that of propofol anesthesia（ P〈0. 05）.Conclusion General anesthesia with combination of propofol and remifentanil was better than sevoflurane combined with remifentanil in reducing IOP in patients with prostatic cancer undergoing Robo-laparoscopic radical prostatectomy.

关 键 词：机器人辅助手术 前列腺癌根治术 气腹 TRENDELENBURG 眼内压 眼灌注压 

分 类 号：R614.2[医药卫生—麻醉学] R339.141[医药卫生—外科学]