日间节律对全身麻醉中麻醉指数和丙泊酚靶控输注浓度的影响  

The Effect of Daytime Rhythm on Anesthesia Index and Propofol Target Controlled Infusion Concentration in General Anesthesia

作　　者：杨海波 杨靖 巩白雪 YANG Haibo;YANG Jing;GONG Baixue(Department of Anesthesiology,Xinjiang 474 Hospital,Urumqi 830000,China;Department of Pharmacy,Xinjiang 474 Hospital,Urumqi 830000,China;Surgery Room of Ophthalmology,Xinjiang 474 Hospital,Urumqi 830000,China)

机构地区：[1]新疆四七四医院麻醉科,乌鲁木齐830000 [2]新疆四七四医院药剂科,乌鲁木齐830000 [3]新疆四七四医院眼科手术室,乌鲁木齐830000

出　　处：《中国医药指南》2024年第21期112-114,共3页Guide of China Medicine

摘　　要：目的探讨日间节律对全身麻醉中麻醉指数和丙泊酚靶控输注浓度的影响。方法采用回顾性抽样方法抽取2016—2021年度于本院妇科均应用舒芬太尼前提下接受腹腔镜手术后的患者病历300份,将其按照手术时间的差异,区分为上午组(手术结束时间为10:00~12:00)和下午组(手术结束时间为15:00~17:00)。比较两组术后疼痛程度变化、心率变化及不良反应发生率,术后苏醒时间、自主呼吸时间以及两组麻醉指数和丙泊酚靶控输注浓度。结果两组患者术后1 h、6 h、12 h的VAS评分均逐渐降低,且下午组患者术后1 h、6 h、12 h的VAS评分均低于上午组(P<0.05)。下午组患者术后1 h、3 h、6 h、12 h的心率均高于上午组(P<0.05)。下午组患者的术后不良反应发生率低于上午组(P<0.05)。下午组患者的术后苏醒时间、自主呼吸时间均短于上午组(P<0.05)。两组患者丙泊酚靶控输注浓度为2μg/ml、2.5μg/ml、3.0μg/ml时、插管前的麻醉指数均逐渐降低,且丙泊酚靶控输注浓度为2μg/ml、2.5μg/ml、3.0μg/ml时、插管前,下午组患者的麻醉指数均低于上午组(P<0.05)。结论日间节律对全身麻醉中麻醉指数和丙泊酚靶控输注浓度有直接的影响,下午比上午的麻醉指数和丙泊酚靶控输注浓度低,且更能将患者的术后疼痛程度减轻,使患者的心率保持稳定,将患者不良反应的发生减少,将患者术后苏醒时间、自主呼吸时间缩短。Objective To explore the effects of daytime rhythm on anesthesia index and propofol target controlled infusion concentration in general anesthesia.Methods A retrospective sampling method was used to select 300 medical records of patients who underwent laparoscopic surgery under the premise of using sufentanil in the gynecology department of our hospital from 2016 to 2021.They were divided into the morning group(surgery end time from 10:00 to 12:00)and the afternoon group(surgery end time from 15:00 to 17:00)according to the difference in surgery time.The changes of pain degree,heart rate,incidence of adverse reactions,postoperative recovery time,spontaneous breathing time,anesthesia index and target controlled infusion concentration of propofol were compared between the two groups.Results The VAS scores of both groups of patients gradually decreased at 1 hour,6 hours,and 12 hours after surgery;At 1 hour,6 hours,and 12 hours after surgery,the VAS scores of patients in the afternoon group were lower than those in the morning group(P<0.05).The heart rate of patients in the afternoon group at 1 hour,3 hours,6 hours,and 12 hours after surgery were higher than those in the morning group(P<0.05).The incidence of postoperative adverse reactions in the afternoon group of patients was lower than that in the morning group(P<0.05).The postoperative recovery time and spontaneous breathing time of patients in the afternoon group were shorter than those in the morning group(P<0.05).The anesthesia index in target controlled infusion concentration of propofol in two groups of patients at 2μg/ml,2.5μg/ml,3.0μg/ml and before intubation gradually decreased,the targeted infusion concentration of propofol at 2μg/ml,2.5μg/ml,3.0μg/ml and before intubation,the anesthesia index of patients in the afternoon group were lower than that in the morning group(P<0.05).Conclusions The daytime rhythm has a direct impact on the anesthesia index and propofol target controlled infusion concentration in general anesthesia,with lower anesthesia

关 键 词：全身麻醉 日间节律 上午 下午 麻醉指数 丙泊酚靶控输注浓度 疼痛程度 

分 类 号：R614.2[医药卫生—麻醉学]