丙泊酚靶控输注在全麻拔管期的应用

目的研究丙泊酚靶控输注（TCI）在全麻拔管期间预防心血管反应的有效性和可行性。方法选择ASAⅠ-Ⅱ级择期行腹部手术患者60例，随机分为丙泊酚组（A组）和对照组（B组）。在拔管条件相同情况下，A组患者行丙泊酚TCI，Marsh模型，血浆靶浓度为1μg／ml，至气管拔管后5min停药；B组不给药，吸痰后拔管。术中连续监测呼吸频率、心率、MAP、SpO2；TCI开始前，吸痰时，拔管时，拔管后5min，10min的呼吸频率、心率、MAP、SpO2及患者的呼吸恢复时间、拔管时间、清醒程度、不良反应等情况。结果A组吸痰时，拔管时，拔管后5min，10min的呼吸频率、心率、MAP较TCI开始前有稍许下降，且A组明显低于B组（P〈0．05），B组吸痰时，拔管时SpO2明显低于基础值（P〈0．05）。结论丙泊酚靶控输注用于全麻拔管期，机体应激反应小，拔管过程中生命体征平稳。

Target controlled infusion for Propofol using in the extubating periods of genenal anesthesia

Objective To study the effectiveness and feasibility of the propofol target-controlled infusion (TCI) in the extubating period of general anesthesia to prevent cardiovascular response.Methods 60 patients who were in the ASA Ⅰ～Ⅱclass and seleetived abdominal surgery were randomly divided into the Propefol group (A) and the control group (B).Extubating in the same eircumstanees and conditions, A group were given with propofol TCI, Marsh model, keep the target plasma concentration as 1μ g/ml. and the drug withdrawal was 5rain after extubating; B group was not given the Propofol TCI,they were extubated after the sputum aspiration.The breathing rate, heart rate, MAP and SpO2 were continuous monitoring in the intraoperative, before using the TCI,during the extubating, 5min and 10min after extubatiug.And the time to recover the breathing, the time for extubating, the conscious level, the adverse effect and so on were also monitoring.Results during the extuhating, 5rain and 10min after the extubating, the breathing rate, the heart rate, MAP were declined slightly than that before using the TCI.And there was significantly lower in the A group than the B group (P < 0.05), B group, The value of SpO2 was significantly lower than the basis of value during extubating and the sputum aspiration(P < 0.05).Conclusions Propofol target-controlled infusion using in the extubating period of general anesthesia, the stress reaction of the body was small,and the vital signs were stable in the process of extubating.