丙泊酚靶控输注麻醉对机器人辅助根治性前列腺切除术患者的影响  

Effect of propofol target-controlled infusion in patients undergoing robot-assisted radical prostatectomy

作　　者：王乙茹 宋田皓 WANG Yiru;SONG Tianhao(Department of Anesthesiology,the Seventh Medical Center,Chinses PLA General Hospital,Beijing 100007,China;Department of Anesthesiology,Jiangsu Cancer Hospital,Nanjing 210009,China)

机构地区：[1]解放军总医院第七医学中心麻醉科,北京100007 [2]江苏省肿瘤医院麻醉科,江苏南京210009

出　　处：《机器人外科学杂志（中英文）》2024年第5期842-846,共5页Chinese Journal of Robotic Surgery

基　　金：江苏省肿瘤医院科技发展基金(ZL202113)。

摘　　要：目的:比较丙泊酚靶控输注麻醉与七氟烷持续吸入两种麻醉方式对机器人辅助根治性前列腺切除术患者的影响。方法:选取中国人民解放军总医院第七医学中心2022年6月—2023年12月收治的80例机器人辅助根治性前列腺切除术患者作为研究对象,采用摸球法分为观察组(n=40,采用丙泊酚靶控输注麻醉)与对照组(n=40,采用七氟烷持续吸入麻醉),对两组患者脑氧饱和度、相关细胞因子水平、调节性T细胞亚型、麻醉恢复时间进行分析。结果:观察组麻醉前5 min(T0)、诱导后5 min(T1)、气腹开始1 h(T2)、手术结束(T3)、清醒时(T4)时脑氧饱和度高于对照组。两组T4时的重组人白细胞介素IL-17A(IL-17A)以及白细胞介素6(IL-6)水平比较,差异有统计学意义,且与T0时比较,两组T4时的IL-17A、IL-6水平升高。观察组各项麻醉恢复时间均短于对照组。两组T4、术后第3 d(T5)时的调节性T细胞亚型相关指标比较,差异有统计学意义,且与T0时比较,两组T4时的调节性T细胞亚型相关指标降低。结论:与七氟烷持续吸入麻醉相比,丙泊酚靶控输注麻醉更能够减轻机器人辅助根治性前列腺切除术患者围手术期的炎性反应,缩短患者恢复意识时间,提高患者恢复意识的质量。Objective:To compare the effects of propofol target-controlled infusion and continuous inhalation of sevoflurane on patients undergoing robot-assisted radical prostatectomy.Methods:80 patients who underwent robot-assisted radical prostatectomy in the Seventh Medical Center of the Chinese PLA General Hospital from June 2022 to December 2023 were selected as the study subjects.They were divided into the observation group(n=40)and the control group(n=40)using the random ball method.The observation group received propofol target-controlled infusion for anesthesia,while the control group received continued inhalation of sevoflurane for anesthesia.Cerebral oxygen saturation,related cytokine levels,regulatory T-cell subtypes,and recovery time from anesthesia were analyzed in the two groups of patients.Results:The cerebral oxygen saturation in the observation group was higher than that in the control group at 5 min before anesthesia(T0),5 min after induction(T1),1 h after pneumoperitoneum(T2),the end of surgery(T3),and at the time of awakening(T4).The difference in levels of recombinant human interleukin IL-17A(IL-17A)and interleukin 6(IL-6)at T4 in the two groups were statistically different,and the levels of IL-17A and IL-6 at T4 were both raised in the two groups compared with those at T0.The recovery time from anesthesia in the observation group was shorter than that in the control group.The difference in regulatory T-cell subtype-related indexes at T4 and 3 d after surgery(T5)of the two groups were statistically significant,and the regulatory T-cell subtype-related indexes at T4 of the two groups were lower compared with those at T0.Conclusion:Compared with continuous inhalation of sevoflurane,propofol target-controlled infusion anesthesia is more capable of reducing the perioperative inflammatory response,shortening the time to regain consciousness,and improving the quality of regaining consciousness in patients undergoing robot-assisted radical prostatectomy.

关 键 词：机器人辅助手术 根治性前列腺切除术 丙泊酚 靶控输注 七氟烷 麻醉恢复时间 脑氧饱和度 

分 类 号：R737.25[医药卫生—肿瘤]