靶控输注丙泊酚麻醉对老年肾肿瘤患者眼内压、眼灌注压及认知功能的影响  

Effects of target-controlled infusion of propofol anesthesia on fundus pressure,ocular perfusion pressure and cognitive function in elderly renal tumor patients

作　　者：胡丽君[1] 孙玉娥[1] 陶佳[1] 李勇[1] HU Li-jun;SUN Yu-e;TAO Jia;LI Yong(Department of Anesthesiology,Drum Tower Hospital,Medical School of Nanjing University,Nanjing 210008,China)

机构地区：[1]江苏省南京大学医学院附属鼓楼医院麻醉科,南京210008

出　　处：《临床药物治疗杂志》2020年第7期48-52,共5页Clinical Medication Journal

摘　　要：目的探讨靶控输注丙泊酚麻醉对老年肾肿瘤患者眼内压、眼灌注压及认知功能的影响。方法将2017年1月至2019年1月在南京市鼓楼医院择期行老年肾肿瘤手术的138例患者作为研究对象,随机分为观察组(69例,给予靶控输注丙泊酚麻醉)和对照组(69例,给予七氟烷持续吸入麻醉)。观察2组患者眼内压及眼灌注压、呼吸恢复时间、拔管时间、术后认知功能障碍评分及不良反应情况。结果诱导前,2组患者IOP及OPP比较,差异均无统计学意义(均P<0.05);建立气腹20 min和60 min时,观察组IOP低于对照组,但OPP高于对照组,差异均显著(P<0.05);观察组睁眼时间、呼吸恢复时间、拔管时间及术后认知功能障碍评分均优于对照组[(13.21±1.27)min vs.(17.83±1.09)min]、[(12.03±2.09)min vs.(16.78±2.98)min]、[(10.91±2.31)min vs.(13.73±1.97)min]、[(28.01±4.63)min vs.(23.12±2.71)min],差异均有统计学意义(均P<0.05);观察组总不良反应发生率明显低于对照组(2.90%vs.14.49%),差异均有统计学意义(P<0.05)。结论靶控输注丙泊酚麻醉在老年肾肿瘤手术中可有效控制眼内压升高,同时可防止眼灌注压降低,不影响认知功能,值得临床推广使用。Objective To investigate the effects of target-controlled infusion of propofol anesthesia on fundus pressure,perfusion pressure,and cognitive function in elderly renal tumor patients.Methods A total of 138 patients undergoing elective renal tumor surgery in Drum tower Hospital from January 2017 to January 2019 were selected as the research objects,and were randomly divided into observation group(69 cases,given target-controlled infusion of propofol anesthesia)and controls group(69 cases,given continuous inhalation anesthesia with sevoflurane).The intraocular pressure(IOP)and ocular perfusion pressure(OPP),respiratory recovery time,extubation time,postoperative cognitive dysfunction scores and adverse reactions were observed in the twogroups.Results Before induction anesthesia,there was no statistically significant difference in IOP and OPP between the two groups(P<0.05);In the first 20 minutes and 60 minutes before establishment of pneumoperiton eum,the IOP in the observation group was lower than the control group,while the OPP was higher than the control group,and the difference was significant(P<0.05);the eye opening time,respiratory recovery time,extubation time,and postoperative cognitive dysfunction scores in the observation group were better than the control group[(13.21±1.27)min vs.(17.83±1.09)min],[(12.03±2.09)min vs.(16.78±2.98)min],[(10.91±2.31)min vs.(13.73±1.97)min],[(28.01±4.63)min vs.(23.12±2.71)min],the differences were significant(all P<0.05);the total adverse reaction rates occurred in the observation group were significantly lower than the control group(2.90%vs.14.49%),the difference was statistically significant(P<0.05).Conclusion Target-controlled infusion of propofol anesthesia can effectively control the increasing of intraocular pressure in elderly renal tumor surgery,prevent the decreasing of ocular perfusion pressure.It can not affect cognitive function,and is worthy of clinical promotion.

关 键 词：靶控输注 老年肾肿瘤 眼底压 眼灌注压 认知功能 

分 类 号：R971.2[医药卫生—药品]