七氟醚复合丙泊酚麻醉用于腹腔镜胆囊切除术的效果及剂量研究  

Efficacy of sevoflurane and propofoi anesthesia for laparoscopic cholecystectomy and dose study

作　　者：付英勇 高秀娟[2] Fu Yingyong;Gao Xiujuan(Department of Anesthesiology, Dongchangfu People＇s Hospital of Liaocheng City, Liaocheng 252000, Chin;Department of Anesthesiology, Liaocheng People＇s Hospital, Liaocheng 252000, China)

机构地区：[1]聊城市东昌府人民医院麻醉科,252000 [2]聊城市人民医院麻醉科,252000

出　　处：《国际医药卫生导报》2018年第11期1688-1692,共5页International Medicine and Health Guidance News

摘　　要：目的观察七氟醚复合丙泊酚麻醉用于腹腔镜胆囊切除术的效果及剂量。方法选择120例腹腔镜胆囊切除术患者进行前瞻洼研究，按随机数字表将人选患者分为A组、B组、C组、D组，各30例。麻醉方案：A组予1％丙泊酚，B组予2％丙泊酚，C组予1％丙泊酚＋七氟醚；D组2％丙泊酚＋七氟醚。比较4组患者意识消失时间、Nareotrend指数降至36所用时间、丙泊酚60rain内使用量、丙泊酚总用量。4组患者T0（入室时）、T1（插管即刻）、T2（切皮时）、T3（关腹时）、T4（拔管时）等时刻的心率（HR）与平均动脉压（MAP）及自主呼吸恢复时间、睁眼时间、拔管时间。结果4组意识消失时间、Narcotrend指数降至36所用时间、丙泊酚60min内使用量、丙泊酚总用量比较差异均有统计学意义（均P〈0．05）；A组与C组意识消失时间、Narcotrend指数降至36所用时间均显著短于B、D组，A、C及B、D组两两比较差异无统计学意义（P〉0．05）；丙泊酚60min内使用量及总用量以B组最高，C组最低，A、D组比较差异无统计学意义（P〉0．05）；4组患者不同时刻的HR、MAP组间比较差异均无统计学意义（均P〉0．05），4组HR组内各时点比较差异均无统计学意义（P〉0．05）；四组T1时MAP均显著低于T0，T2时均显著高于T0（P〈0．05）；C组与D组患者的自主呼吸恢复时间、睁眼时间、拔管时间均显著短于A组与B组（均P〈0．05）。结论与丙泊酚全凭静脉麻醉相比，七氟醚复合丙泊酚麻醉用于腹腔镜胆囊切除术可获得更佳的苏醒质量，且1％丙泊酚的药效动力学更佳，可减少丙泊酚用量。七氟醚复合1％丙泊酚为腹腔镜胆囊切除术的理想麻醉方案。Objective To observe the effect and dose of sevoflurane combined with propofol anesthesia for laparoscopic cholecystectomy. Methods A total of 120 patients undergoing laparoscopic cholecystectomy were prospectively studied. According to the random number table, the patients were divided into group A, group B, group C, and group D, with 30 cases in each group. Anesthesia program： group A of 1% propofol, group B of 2% propofol, group C of 1% propofol ＋ sevoflurane, group D of 2% propofol ＋ sevoflurane. The time of consciousness disappearance, the time of Narcotrend index down to 36, the dosage of propofol within 60 min, and the total dosage of propofol, heart rate （HR） and mean arterial pressure （MAP） at T0 （entering the room）, T1 （intubating）, T2 （incising）, T3 （abdomen closing）, T4 （extubation）, the recovery time of spontaneous breathing, eye opening time, extubation time were compared among the four groups. Results There were statistically significant differences in the time of consciousness disappearance, the time of Narcotrend index down to 36, the dosage of propofol within 60 min, and the total dosage of propofol among the 4 groups （P〈0.05）; the time of consciousness disappearance, the time of Narcotrend index down to 36 in group A and C were significantly shorter than those in group B and D （P〈0.05）, there were no statistically significant differences between group A and C, group B and D （P〉0.05）. The dosage of propofol within 60 min and the total dosage of propofol were the highest in group B, the lowest in group C, there were no statistically significant differences between group A and D （P〉0.05）. There were no statistically significant differences in HR and MAP among the four groups at each time point （P〉0.05）; there were no statistically significant differences in HR at different time points in each group （P〉0.05）; MAP in the 4 groups at T1 were significantly lower than those at To, and MAP in the 4 groups at T2 were significantly high

关 键 词：腹腔镜胆囊切除术 七氟醚 丙泊酚 剂量 

分 类 号：R614[医药卫生—麻醉学]