依托咪酯辅助丙泊酚麻醉对无痛人流手术患者麻醉效果的影响  

Effects of etomidate assisted propofol anesthesia in patients undergoing painless induced abortion

作　　者：牛民强 谢小娟[2] 司建洛[2] Niu Min-qiang;Xie Xiao-juan;Si Jian-luo(Department of Anesthesiology,Zhengzhou Huazhuo Hospital,Xingyang 450100,Henan,China;Department of Anesthesiology,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,China)

机构地区：[1]郑州华卓医院麻醉科,河南荥阳450100 [2]河南科技大学第一附属医院麻醉科,河南洛阳471000

出　　处：《四川生理科学杂志》2023年第9期1563-1566,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:探究依托咪酯(Etomidate,ETO)辅助丙泊酚(Propofol,PRO)对无痛人流手术患者麻醉效果的影响。方法:收集我院2020年4月至2022年4月收治的146例接受无痛人流手术患者,按麻醉方案不同,分成ETO辅助组及PRO麻醉组,各73例。PRO麻醉组接受PRO麻醉,ETO辅助组在PRO麻醉组的基础上给予ETO辅助麻醉。对比两组麻醉起效时间、PRO用量、术后苏醒时间、不同时间点血流动力学、视觉模拟评分法(Visual analogue scale,VAS)评分、疼痛介质、应激指标、不良反应发生率。结果:T1、T2、T3时刻,ETO辅助组平均动脉压和心率稳定性好于PRO麻醉组(P<0.05);T2、T3、T4时刻,ETO辅助组VAS评分低于PRO麻醉组(P<0.05);ETO辅助组麻醉起效时间、术后苏醒时间均短于PRO麻醉组,PRO用量少于PRO麻醉组(P<0.05);T3、T4时刻,ETO辅助组血清P物质、神经肽Y、前列腺素E2水平低于PRO麻醉组(P<0.05);T5、T6时刻,ETO辅助组血清去甲肾上腺素(Noradrenaline,NE)、血管紧张素-Ⅱ(Angiotensin,Ang-Ⅱ)、皮质醇水平低于PRO麻醉组(P<0.05);ETO辅助组不良反应总发生率低于PRO麻醉组(P<0.05)。结论:ETO辅助PRO麻醉用于无痛人流手术患者麻醉起效及术后苏醒时间更短,PRO用量更少,对血流动力学的稳定性较好,疼痛感及应激反应较轻,有助于降低不良反应发生风险。Objective:To explore the effect ofetomidate(ETO)assisted propofol(PRO)anesthesia in patients undergoing painless induced abortion.Methods:The146 patients undergoing painless abortion surgery in our hospital from April 2020to April 2022were collected and divided into ETO assistedgroup(n=73)and PROgroup(n=73)according to different anesthesia schemes.The PRO groupreceived PRO anesthesia,and the ETO assisted groupreceived ETOanesthesiabased onPRO group.The onset time of anesthesia,dosage of PRO,postoperative recovery time,hemodynamics,visual analogue scale(VAS)at different time points,pain mediators,stress indicators,the incidence of adverse reactionswerecompared between ETO assistedgroup and PROgroup.Results:At T1,T2,and T3,the stability of mean arterial pressureand heart ratein ETO assisted group were better than those in PRO group(P<0.05).At T2,T3,and T4,the VAS scorein the ETO assisted groupwaslower than thatin the PROgroup(P<0.05);the onset timeof anesthesia and postoperative recovery time in the ETO assisted groupwere shorter than those in the PROgroup,and the dosage of PRO was less than that in the PROgroup(P<0.05).At T3 and T4,serum levelsof substance P,neuropeptide Y and prostaglandin E2 in the ETO assisted groupwere lower than those in the PRO group(P<0.05).At T5 and T6,serum levelsof norepinephrine(NE),angiotensin-Ⅱ(Ang-Ⅱ),cortisolin the ETO assistedgroup were lower than those in the PRO group(P<0.05).The total incidence rate of adverse reactionsin ETO assistedgroupwas lower than that inthe PRO group(P<0.05).Conclusion:ETO assistedPRO in patients with painless abortion has a short onsettimeof anesthesia and postoperative recovery time,less PRO dosage,less pain and stress,and helps reduce the risk of adverse reactions.The effect is worthy of recognition.

关 键 词：依托咪酯 丙泊酚 无痛人流 疼痛介质 应激反应 

分 类 号：R614[医药卫生—麻醉学]