不同时间注射丙泊酚对全麻病人气管拔管反应及麻醉苏醒的影响

目的：探讨不同时间注射丙泊酚对全麻病人气管拔管反应及麻醉苏醒的影响。方法：20～60岁病人120例行腹部手术，ASA分级Ⅰ～Ⅱ级，无肝肾及内分泌系统疾病，随机分为4组，每组30例。Ⅰ组：对照组，满足拔管指征即拔管；Ⅱ组：满足拔管指征，丙泊酚用药后1min拔管；Ⅲ组：满足拔管指征，丙泊酚用药后5min拔管；Ⅳ组：满足拔管指征，丙泊酚用药后10min拔管；监测麻醉诱导前、术毕丙泊酚注射前、拔管时、拔管后5min时心率、血氧饱和度、血压，记录各组拔除气管至清醒对答的时间等情况。结果：气管拔管时Ⅱ组和Ⅲ组心血管反应、躁动明显低于Ⅰ组（P〈0．05），Ⅲ组清醒时间、低血氧饱和度明显高于Ⅰ组（P〈0．05），Ⅳ组心血管反应、清醒时间、躁动、清醒时间、低血氧饱和度较Ⅰ组差异无统计学意义（P〉0．05）。结论：全麻病人术毕有拔管指征，立即注射丙泊酚1mg／kg，用药后5min行气管拔管是安全、有效的。

Effect of Injecting Propofol at Different time on Extubation Response and Anesthesia Wakeup in Patienta Subject to General Anesthtization

Objective： To investigate Effect of Injecting Propofol at Different times on Extubation Response and Anesthesia Wakeup in Patients Subject to General Anesthtization. Methods： A series of 120 patients, ranging in age from 20 to 60, received abdominal surgery. ASA grading was Ⅰ-Ⅱ. No disease was detected in the liver, kidney and endocrine system in each patient. They were divided at random into 4 groups, each including 30 cases. Group Ⅰ was the control group in which extubation was conducted as they met the extubation indications. In Group Ⅱ, Ⅲ and Ⅳ, extubation was conducted when they met the extubation indications 1,5 and 10 minutes after administration of propofol, respectively. Heart rate （HR）, oxygen saturation （SpO2） and mean arterial pressure （MAP） were monitored before the induction of anesthesia, after the operation, before injecting propofol, at the time of extubation and 5 minutes after extubation. The status of the patients from the time of extubation to sober answer was taken down. Results： On extubation, cardiovascular response and restless were dramatically lower in Group Ⅰ （ P〈0.05）. Sober time and SpO2 in group Ⅱ were significantly higher than those in Group Ⅰ （ P 〈0.05）. There was no remarkable difference in cardiovascular response, sober time, restless and low SpOz between GroupⅡ and Group Ⅰ （ P 〈0.05）. Conclusion： In the patients receiving general anesthesia, extubation should be performed 5 minutes after immediate injection of propofol at a dose of 1 mg/kg when they showed extubation indications.