丙泊酚对帕金森病患者全身麻醉诱导的应用效果  

Application of propofol in the induction of general anesthesia in patients with Parkinson’s disease

作　　者：聂超然 李京生[1] 高鑫 王天龙[1] Nie Chaoran;Li Jingsheng;Gao Xin;Wang Tianlong(Department of Anesthesiology and Operating Theater,Xuanwu Hospital,Capital Medical University,National Clinical Research Center for Geriatric Disorders,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院麻醉手术科,国家老年疾病临床医学研究中心,北京100053

出　　处：《北京医学》2022年第2期128-131,共4页Beijing Medical Journal

基　　金：北京市属医学科研院所公益发展改革试点项目(京医研2019-2)。

摘　　要：目的 探讨丙泊酚用于帕金森病(Parkinson’s disease, PD)患者全身麻醉诱导时的药物剂量及患者的血流动力学变化。方法 选取2018年3月至2019年3月首都医科大学宣武医院择期全身麻醉下行立体定向脑深部电刺激术的PD患者(E组)及择期行全身麻醉手术治疗的非PD患者(C组)各40例。采用丙泊酚靶控输注进行诱导,记录患者意识指数(index of consciousness, IoC1)降至<60时丙泊酚的效应室浓度、IoC1数值及患者的MAP。比较两组麻醉诱导所需丙泊酚的效应室浓度及血流动力学变化。结果 E组丙泊酚效应室浓度为(2.41±0.33)mg/L,低于C组的(3.06±0.31)mg/L,差异有统计学意义(P=0.000)。麻醉诱导后,两组IoC1、HR、SBP、DBP及MAP均下降,且E组SBP和MAP均低于C组[(109.7±11.7)mmHg比(117.7±8.8)mmHg和(80.1±7.3)mmHg比(84.2±5.9)mmHg,1 mmHg=0.133 kPa],差异均有统计学意义(P=0.001和0.006)。结论 全身麻醉诱导PD患者时所用丙泊酚剂量低于非PD患者,且PD患者的血流动力学不稳定。Objective To investigate the dosage and hemodynamic changes of propofol during induction of general anesthesia in patients with Parkinson’s disease(PD). Methods A total of 40 patients with PD who underwent stereotactic deep brain electrical stimulation under elective general anesthesia(group E) and 40 patients with non-PD who underwent elective surgical treatment with general anesthesia(group C) at Xuanwu Hospital, Capital Medical University from March2018 to March 2019 were selected. Propofol target controlled infusion was used for general anesthesia induction. The effect chamber concentration of propofol, index of consciousness(IoC1) value and patient’s MAP were recorded when IoC1decreased below 60. The effect chamber compartment concentration of propofol and the hemodynamic change between the two groups were compared. Results The effect chamber concentration of propofol in group E was(2.41 ± 0.33) mg/L, which was lower than that in group C [(3.06 ± 0.31) mg/L], the difference was statistically significant(P = 0.000). After anesthesia induction, IoC1, HR, SBP, DBP and MAP decreased in both groups, the SBP and MAP in group E were lower than those in group C [(109.7 ± 11.7) mmHg vs.(117.7 ± 8.8) mmHg,(80.1 ± 7.3) mmHg vs.(84.2 ± 5.9) mmHg, 1 mmHg = 0.133 kPa],the differences were statistically significant(P = 0.001 and 0.006). Conclusions The dose of propofol in the patients with PD is less than those without PD during general anesthesia induction. And the hemodynamic changes in the patients with PD are more unstable than those in the patients without PD during general anesthesia induction.

关 键 词：帕金森病 丙泊酚 意识指数 靶控输注 麻醉诱导 

分 类 号：R614.2[医药卫生—麻醉学]