丙泊酚分步靶控输注对全麻诱导期血流动力学的影响

目的 观察丙泊酚分步靶控输注对腹腔镜胆囊切除术患者全身麻醉诱导插管过程血流动力学的影响.方法 选择42例ASAⅠ～Ⅱ级行择期腹腔镜胆囊切除术患者,随机分为实验组(T组)和对照组(C组),每组21例.麻醉诱导T组采用丙泊酚静脉分步靶控输注,血浆靶浓度从1.0 mg·L-1开始递增,递增梯度为0.5 mg·L-1,每靶浓度输注1 min,目标靶浓度设定为3.0 mg·L-1;C组采用人工单次静脉注射丙泊酚2 mg·kg-1,同时两组均给予芬太尼2 μg·kg-1,罗库溴铵0.9 mg·kg-1静脉推注后行气管插管.连续监测并记录患者诱导前(T1)、插管前(T2)、插管即刻(T3)和插管后5 min(T4)血压(SBP/DBP)和心率(HR)并计算RPP.结果 T组全麻诱导过程中各时点血压、心率和RPP无统计学差异(P>0.05),而对照组插管前(T2)插管即刻(T3)和插管后5 min(T4)血压、心率和RPP与诱导前(T1)和C组相比较差异均具有统计学意义(P<0.01).结论 丙泊酚分步递增靶控输注诱导有利于维持腹腔镜胆囊切除术患者全麻诱导插管期的血流动力学稳定.

Effects of multistep target controlled infusion Propofol on the hemodynamics during general anesthesia induction

Objective To observe the effects of multistep target controlled infusion propofol on the hemodynamics during general anesthesia induction.Methods Fourty-two ASA Ⅰ or Ⅱ patients undergoing elective laparoscopic cholecystectomy were randomly divided into two groups:test group(n=21,group T)and Control group(n=21,group C).Patients in test group received multistep target controlled infusion propofol while those in the control group received manual continue infusion Propofol.SP,DP and HR of all patients were recorded on before induction,before intubation,1 and 5min after intubation respectively.Result SP,DP and HR were lower at before intubation and higher at 1 and 5 min after intubation than those preoperatively in group C(P<0.01 or P<0.05).Conclusions Multistep target controlled infusion propofol can cause no significant effect on the hemodynamics during general anesthesia induction.