年龄因素对丙泊酚闭环靶控输注用于妇科腹腔镜手术患者镇静效果的影响  

Effect of age factor on sedative efficacy of propofol given by closed-loop infusion in patients undergo-ing gynecological laparoscopic surgery

作　　者：李红[1] 刘叶 吴军娜 岳婷[1] 何锟[1] 苏江涛[1] 刘淑香[1] Li Hortg, Liu Ye, Wu Junna, Yue Ting, He Kun, Su Jiangtao , Liu Shuxiang,(Department of Anesthesiology, Shijiazhuang Fourth Hospital, Hebei 050000, China)

机构地区：[1]石家庄市第四医院麻醉科,050000

出　　处：《中华麻醉学杂志》2018年第5期565-567,共3页Chinese Journal of Anesthesiology

摘　　要：目的评价年龄因素对丙泊酚闭环靶控输注用于妇科腹腔镜手术患者镇静效果的影响。方法择期行妇科腹腔镜手术患者100例，体重55～75kg，ASA分级I或Ⅱ级．根据年龄分为2组（n=50）：中年组（45～64岁）和老年组（65～75岁）。采用丙泊酚闭环靶控输注，自动调节血浆靶浓度，维持BIS值目标范围45-55，靶控输注瑞芬太尼，血浆靶浓度为2～6ng／ml维持麻醉，间断注射顺式阿曲库铵维持肌松。记录丙泊酚和瑞芬太尼的总用量、丙泊酚调整频率、BIS40-60时间比率和反映闭环系统整体性能的总体评分、苏醒时间、气管拔管时间。结果与中年组比较，老年组BIS40-60时间比率升高，总体评分降低，丙泊酚和瑞芬太尼的总用量降低，丙泊酚调整频率升高（P〈0．05），苏醒时间和气管拔管时间差异无统计学意义（P〉0．05）。结论丙泊酚闭环靶控输注用于妇科腹腔镜手术患者的镇静效果受年龄因素的影响，用于老年患者的稳定性优于中年患者。Objective To evaluate the effect of age factor on the sedative efficacy of propofol given by closed-loop infusion in patients undergoing gynecological laparoscopie surgery. Methods A total of 100 patients, weighing 55-75 kg, of American Society of Anesthesiologists physical status I or lI, scheduled for elective gynecological laparoscopic surgery under general anesthesia, were divided into 2 groups （n = 50 each） according to age： middle-aged group （45-64 yr） and elderly group （65-75 yr）. Propofol was given by closed-loop infusion, and the target plasma concentration was automatically regulated to maintain bispee- tral index （BIS） value within the target range of 45-55. Remifentanil was given by target-controlled infu- sion at a target plasma concentration of 2-6 ng/ml to maintain anesthesia, and eisatracurium was injected intermittently to maintain muscle relaxation. The total consumption of propofol and remifentanil, regulating frequency of propofol, time ratio of BIS40.60, global score reflecting performance of closed-loop infusion sys- tem, emergence time and extubation time were recorded. Results Compared with middle-aged group, the time ratio of BIS40_60 was significantly increased, global score was decreased, the total consumption of propofol and remifentanil was significantly decreased, the regulating frequency of propofol was increased （ P〈0. 05 ）, and no significant change was found in emergence time or extubation time in elderly group （ P〉 0. 05）. Conclusion The sedative efficacy of propofol given by closed-loop infusion is influenced by age factors when used for gynecologic laparoscopic surgery, and the stability in elderly patients is superior to that in middle-aged patients.

关 键 词：二异丙酚 药物释放系统 年龄因素 老年人 

分 类 号：R614[医药卫生—麻醉学]