环泊酚对体外循环下二尖瓣置换术麻醉诱导期的血流动力学影响  

Hemodynamic effects of ciprofol on the anesthetic induction period of mitral valvereplacement surgery under cardiopulmonary bypass

作　　者：宋波 张永洪[1] 李军[1] 彭健 胡玉涛 SONG Bo;ZHANG Yonghong;LI Jun;PENG Jian;HU Yutao(Mianyang Key Laboratory of Anesthesiology and Neuroregulation/Department of Anesthesiology,Mianyang Central Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]绵阳市麻醉科与神经调控重点实验室/绵阳市中心医院麻醉科,四川绵阳621000

出　　处：《重庆医学》2024年第9期1339-1343,共5页Chongqing medicine

基　　金：2022年度发育与再生四川省重点实验室开放基金项目(SYS22-03)。

摘　　要：目的通过血流动力学监测明确环泊酚、丙泊酚对二尖瓣置换术患者诱导期血流动力学及心脏做功的影响。方法选取该院2022年6月至2023年6月拟接受体外循环下二尖瓣置换术患者90例,随机分成2组,环泊酚组(P组,n=45)、丙泊酚组(B组,n=45)。观察患者给药前(T_(0))和给药后5 min(T_(1))的心率(HR)、血氧饱和度(SpO_(2))、脑频双电指数镇静指数(ICO1)、平均动脉压(MAP)、中心静脉压(CVP)、每搏量(SV)、心输出量(CO)、外周血管阻力(SVR)、心脏循环效率(CCE)、每搏变异度(SVV)、反映心肌收缩力的最大压力梯度(dp/dt)。结果P组T_(1)时ICO1、MAP、SV、CO和SVR较T_(0)时下降,CCE较T_(0)时升高,差异有统计学意义(P<0.01、P<0.05);B组T_(1)时ICO1、MAP、CVP、SV、CO、SVR、CCE、SVV、dp/dt较T_(0)时下降,差异有统计学意义(P<0.01、P<0.05)。B、P两组T_(0)时HR、SpO_(2)、ICO1、MAP、CVP及血流动力学指标比较,差异无统计学意义(P>0.05);B、P两组T_(1)时HR、SpO_(2)、ICO1、CVP、SVV比较差异也无统计学意义(P>0.05);P组T_(1)时MAP、SV、CO、SVR、CCE、dp/dt高于B组,差异有统计学意义(P<0.05)。结论环泊酚在体外循环下二尖瓣置换术麻醉诱导时期能较好地保持血流动力学稳定,降低心功能损害。Objective To determine the effects of ciprofol and propofol on hemodynamics and cardiac work were determined by hemodynamic monitoring,so as to provide reference for anesthesia induction in cardiac surgery.Methods A total of 90 patients scheduled for mitral valve replacement under cardiopulmonary bypass from June 2022 to June 2023 were randomly divided into two groups:the ciprofol group(group P,n=45)and the propofol group(group B,n=45).The heart rate(HR),oxygen saturation(SpO_(2)),index of consciousness(ICO1),mean arterial pressure(MAP),central venous pressure(CVP),stroke volume(SV),cardiac output(CO),systemic vascular resistance(SVR),cardiac cycle efficiency(CCE),stroke volume variation(SVV),maximum pressure gradient reflecting myocardial contractility(dp/dt)were recorded before administration(T_(0))and five min after administration(T_(1)).Results In group P,ICO1,MAP,SV,CO,and SVR at T_(1)were lower than those at T_(0),and CCE was higher than that at T_(0)(P<0.01,P<0.05).In group B,ICO1,MAP,CVP,SV,CO,SVR,CCE,SVV,dp/dt at T_(1)were significantly lower than those at T_(0)(P<0.01,P<0.05).There was no statistically significant difference in HR,SpO_(2),ICO1,MAP,CVP and hemodynamic indicators between group B and group P at T_(0)(P>0.05).There was no statistically significant difference in HR,SpO_(2),ICO1,CVP and SVV between group B and group P at T_(1)(P>0.05).MAP,SV,CO,SVR,CCE and dp/dt at T_(1)in group P were higher than those in group B(P<0.05).Conclusion Ciprofol can better maintain hemodynamic stability and reduce cardiac impairment during the induction phase of mitral valve replacement surgery under cardiopulmonary bypass.

关 键 词：环泊酚 诱导 二尖瓣置换 血流动力学 

分 类 号：R614[医药卫生—麻醉学]