依托咪酯乳剂对腹腔镜子宫手术患者的麻醉恢复及MAP、HR变化的影响

【目的】探讨依托咪酯乳剂对腹腔镜子宫手术患者的麻醉恢复及平均动脉压(MAP)、心率(HR)的变化的影响。【方法】本院行腹腔镜子宫手术患者120例,根据麻醉不同分为两组。对照组给予丙泊酚联合瑞芬太尼全凭静脉麻醉,观察组给予依托咪酯乳剂联合瑞芬太尼全凭静脉麻醉,比较两组麻醉及手术情况。【结果】两组麻醉前(T0)、气管插管后即刻(T1)、平卧位无气腹后10min(T3)时MAP、HR水平及大脑中动脉收缩期峰值流速(MCA-PSV)、搏动指数(PI)水平组间比较差异无显著性(P>0.05)。观察组气腹头低位即刻(T2)时MAP水平低于对照组,但HR水平及MCA-PSV、PI与对照组比较差异无显著性(P>0.05)。观察组睁眼时间、气管拔管时间、定向力障碍消失时间均短于对照组,且两组比较差异均有显著性(P<0.05)。观察组恶心呕吐发生率为1.67%(1/60)、肌颤发生率为1.67%(1/60)与对照组比较差异无显著性(P>0.05)。观察组注射痛发生率0.00%(0/60)低于对照组10.00%(6/60),且差异有显著性(P<0.05)。【结论】依托咪酯乳剂应用于腹腔镜子宫手术可促进患者麻醉恢复,对MAP、HR、脑血流量影响较小,且安全性高。

Effect of Etomidate Emulsion on Anesthesia Recovery and changes of MAP and HR in Patients undergoing Laparoscopic Hysterectomy

【Objective】To investigate the effects of etomidate emulsion on anesthesia recovery and changes of mean arterial pressure(MAP)and heart rate(HR)in patients undergoing laparoscopic uterine surgery.【Methods】A total of 120 patients undergoing laparoscopic hysterectomy were divided into two groups according to anesthesia methods.Patients in the control group received propofol combined with remifentanil by intravenous anesthesia,while patients in the observation group received etomidate emulsion combined with remifentanil by intravenous anesthesia.The anesthesia and operation procedure of the two groups were compared.【Results】MAP,HR level,PI(pulsatility index)and MCA-PSV(peak systolic velocity of middle cerebral artery)showed no significant differences between the two groups before anesthesia(T0),immediately after endotracheal intubation(T1),10 min after no pneumoperitoneum in supine position(T3)(P>0.05).The MAP level at T2(low head position with pneumoperitoneum)in the observation group was lower than that in the control group,however,the HR,MCA-PSV and PI in the observation group were not significant from the control group(P>0.05).Eye opening tim e,tracheal extubation time and disorientation timer in observation group was shorter than those in the control group;and the differences between the two groups were statistically significant(P<0.05).The incidence of nausea and vomiting in the observation group was 1.67%(1/60)and the incidence of muscle fibrillation was 1.67%(1/60),which were not significant difference with those in the control group(P>0.05).The incidence of injection pain in the observation group was 0.00%(0/60),which was lower than that in the control group(10.00%,6/60)(P<0.05).【Conclusion】The application of etomidate emulsion in laparoscopic hysterectomy can promote the recovery of anesthesia.It has little effect on the cerebral blood flow,MAP and HR.