丙泊酚靶控输注全麻诱导时机体应激反应的临床研究  

A clinical study on the stress response to anesthesia induction using target controlled infusion of propofol

作　　者：韩新生[1] 吕建瑞[1] 薛荣亮[1] 丁晓英[1] 李有才[1] 张延均[2] 

机构地区：[1]西安交通大学第二医院麻醉科,710004 [2]西安交通大学第二医院检验科,710004

出　　处：《临床麻醉学杂志》2003年第6期343-345,共3页Journal of Clinical Anesthesiology

摘　　要：目的　观察丙泊酚靶控输注 (TCI)用于全麻诱导对皮质醇、血糖和心率变异性 (HRV)的影响。方法　 48例全麻插管病人随机分为两组 ,A组采用Diprifusor/TCI系统分六步诱导给药 ,B组人工推注丙泊酚。观察心率、血压、SpO2 、ECG、HRV ,并于诱导前 (T0 )、意识消失时 (T1)、插管时(T2 )、插管后 1min(T3 )、3min(T4 )、5min(T5)抽取静脉血检测血糖、皮质醇。结果　A组心率、DBP、SpO2 、血糖和皮质醇各时点无明显差异 ,HRV、SBP各时点较T0 明显降低 (P <0 0 5 ) ,但插管前后无明显差异 ;B组T1、T2 的心率、血压明显低于T0 和T3 、T4 、T5,也明显低于A组各时点 (P <0 0 5 ) ,T3 的HF、血糖、皮质醇明显高于T0 和其他各时点及A组 (P <0 0 5 ) ,而LF/HF明显低于T0 、T1和T5及A组 (P <0 0 5 )。结论　丙泊酚TCI用于全麻诱导插管时机体应激反应小 ,诱导过程中生命体征平稳。Objective To observe the changes of cortisol,blood glucose and heart rate variability (HRV)during general anesthesia induction with target controlled infusion(TCI)of propofol.Methods 48 patients were divided into two groups randomly.Group A was induced using Diprifusor/TCI system in 6 steps.Propofol 2mg/kg was injected manually in group B.HR,BP,SpO 2,ECG,HRV and blood glucose,cortisol were recorded before induction(T 0),at the time of lost of consciousness(T 1),during intubation(T 2),at 1min(T 3),3min(T 4) and 5min after intubation (T 5).Results There was no obvious difference in HR,SpO 2,DBP,cortisol and blood glucose between T 0 and T 1-T 5.HRV and SBP of T 1-T 5 were obviously lower than those of (T 0),which was not obviously different between before intubation and after intubation in group A.HR and BP at T 1 and T 2 were obviously lower than those at T 0,T 3,T 4,and T 5 in group B and lower than those at corresponding points in group A(P<0.05).HF,blood glucose and cortisol at T 3 were obviously higher than those at T 0,T 2 in group B and at corresponding points in group A(P<0.05),but LF/HF at T 3 was obviously lower than that at T 0,T 1,T 5 in group B and at corresponding points in group A(P<0.05).Conclusions TCI of propofol with Diprifusor system can decrease the stress response to anesthesia induction.

关 键 词：丙泊酚 靶控输注 全麻 诱导 应激反应 临床研究 

分 类 号：R614.2[医药卫生—麻醉学]