术中小剂量依托咪酯乳剂麻醉维持对腹腔镜胃癌根治手术患者术后苏醒期影响的临床观察  

Effects of anesthetic maintenance with low-dose etomidate emulsion on the recovery period of patients undergoing laparoscopic radical gastrectomy

作　　者：李强 魏静秋 朱珊珊 芦博 张锋 刘鹤 LI Qiang;WEI Jingqiu;ZHU Shanshan;LU Bo;ZHANG Feng;LIU He(Department of Anesthesiology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221002,China)

机构地区：[1]徐州医科大学附属医院麻醉科,江苏徐州221002

出　　处：《徐州医科大学学报》2022年第2期97-101,共5页Journal of Xuzhou Medical University

基　　金：2018年徐州市临床技术骨干研修计划(2018211006)。

摘　　要：目的观察术中小剂量依托咪酯乳剂麻醉维持对腹腔镜胃癌根治术患者术后苏醒期的影响。方法选择徐州医科大学附属医院择期全身麻醉下行腹腔镜胃癌根治术患者60例,采用随机数字表法随机分为依托咪酯乳剂组(E组)和丙泊酚组(P组)(n=30):E组采用小剂量依托咪酯麻醉维持,P组采用小剂量丙泊酚麻醉维持。分别记录2组患者术后苏醒时间(t_(1))、拔管时间(t_(2))、拔管后在麻醉恢复室(PACU)监护停留时间(t_(3)),以及2组患者不同时间点的心率(HR)、收缩压(SBP)、舒张压(DBP)、心率-收缩压乘积(RPP)、脉搏氧饱和度(SpO_(2))、Riker镇静躁动评分、Steward苏醒评分、血管活性药物使用和不良事件发生率情况。结果与P组相比,E组患者术后苏醒时间(t_(1))、拔管时间(t_(2))稍长,苏醒期血流动力学更平稳,血管活性药物使用更少(P<0.05)。2组患者SpO_(2)、Steward评分及不良事件发生率差异无统计学意义(P>0.05)。结论小剂量依托咪酯乳剂用于腹腔镜胃癌根治术患者术中麻醉维持,尽管患者苏醒时间有所延长,但对患者苏醒期血流动力学影响较小,且不增加术后不良事件发生率。Objective To observe the effect of anesthesia maintenance with low-dose etomidate emulsion on the recovery period of patients with gastric cancer undergoing laparoscopic radical gastrectomy.Methods A total of 60 patients with gastric cancer who were scheduled to undergo laparoscopic radical gastrectomy under general anesthesia were enrolled.According to the random number table method,they were divided into two groups(n=30):group E and group P.In group E,low-dose etomidate was used for anesthetic maintenance,while group P was maintained with low-dose propofol.Then,their postoperative recovery time(t_(1)),extubation time(t_(2)),and the length of post anesthesia care unit(PACU)stay(t_(3))were recorded,while both groups were compared for heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),rate-pressure product(RPP),pulse oxygen saturation(SpO_(2)),Riker sedation-agitation scores and Steward recovery scores at different time points.Furthermore,the use of vasoactive agents and the incidence of adverse reactions were recorded.Results Compared with group P,patients in group P presented extended t_(1)and t_(2),with more stable hemodynamics,and reduced use of vasoactive drugs(P<0.05).There was no statistical difference between the two groups in SpO_(2),Steward scores and the incidence of adverse reactions(P>0.05).Conclusions Anesthesia maintenance with low-dose etomidate emulsion has little effect on the hemodynamics of patients undergoing laparoscopic radical gastrectomy at the recovery period,which is safe and feasible,and does not increase the incidence of adverse reactions.

关 键 词：依托咪酯乳剂 苏醒期 腹腔镜 胃癌 

分 类 号：R614.2[医药卫生—麻醉学]