依托咪酯联合丙泊酚在复杂外科手术中麻醉诱导阶段的对比研究  

Comparative study of etomidate combined with propofol during induction of anesthesia in complex surgery

作　　者：刘华天 孙波[1] 郭雷[1] 王乐[1] LIU Hua-tian;SUN Bo;GUO Lei;WANG Le(Department of Anesthesiology,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院麻醉科

出　　处：《哈尔滨医科大学学报》2019年第5期532-535,共4页Journal of Harbin Medical University

摘　　要：目的对比研究在复杂手术诱导阶段(如普外科中的肝脏,胰腺手术),依托咪酯和丙泊酚的血流动力学变化规律。方法选取2017年7月至2019年3月37~62岁的成年患者,接受择期复杂手术手术患者共92例。按诱导药物种类分为3组,丙泊酚组(P组)30例,依托咪酯组(E组)28例,依托咪酯联合丙泊酚组(C组)34例。采取有创血压监测,记录患者的年龄,各时间点的有创血压的平均动脉、心率及各组肌颤例数,注射痛例数,术后呕吐例数。结果在复杂手术如肝脏外科手术,胰腺外科及神经外科手术患者诱导阶段,依托咪酯联合丙泊酚组在诱导期的循环波动性要低于丙泊酚组和依托咪酯组。且依托咪酯联合丙泊酚组在肌颤发生率要低于依托咪酯组,注射痛三组无明显差别,术后恶心呕吐发生率无明显差别。结论依托咪酯联合丙泊酚在复杂手术中诱导期较丙泊酚和依托咪酯循环波动更加稳定且肌颤发生率较依托咪酯更少,较适合应用于复杂手术全身麻醉的静脉诱导。Objective To compare the hemodynamic changes of etomidate and propofol during the induction phase of complex surgery(such as liver and pancreas surgery in general surgery. Methods From July 2017 to March 2019, 92 adult patients aged 37~62 were selected, and 92 patients underwent elective complex surgery. They were divided into three groups according to the types of induced drugs. There were 30 cases in propofol group(group P), 28 cases in etomidate group(group E) and 34 cases in etomidate combined with propofol group(group C). Invasive blood pressure monitoring was used. The patients’ age, the average arterial and heart rate of invasive blood pressure at each time point were recorded. The number of cases of myofibrillation, injection pain, and vomiting after operation were also recorded. Results During the induction phase for patients undergoing complex operations such as liver surgery, pancreatic surgery and neurosurgery, the cyclic fluctuation of group C was lower than that of group P and group E(P<0.05). The incidence of myofibrillation in group C was lower than that in group E(P<0.05). There was no significant difference in the incidence of injection pain and postoperative nausea and vomiting among the three groups(P>0.05). Conclusion The induction period of etomidate combined with propofol is more stable than propofol and etomidate, and the incidence of myofibrillation of etomidate combined with propofol is less than that of etomidate, so that etomidate combined with propofol is more suitable for intravenous induction of general anesthesia in complex surgery.

关 键 词：静脉麻醉 麻醉诱导 丙泊酚 依托咪酯 

分 类 号：R614[医药卫生—麻醉学]