异丙酚预防腹腔镜胆囊切除术后病人恶心呕吐发生的最佳剂量研究

目的：探讨异丙酚预防腹腔镜胆囊切除术后病人术后恶心呕吐（踟）发生的最佳剂量。方法：选择ASA Ⅰ-Ⅱ级在全麻下行腹腔镜胆囊切除术病人80例，随机分为四组：C组（输入0．9％氯化钠注射液，n=40）、P0.5组（异丙酚0．5mg·Kg^-1·h^-1，n=40）、P1.0组（异丙酚1．0mg·Kg^-1·h^-1，n=40）和P1.5组（异丙酚1．5mg·Kg^-1·h^-1，n=40）。所有药物在病人麻醉诱导后开始输注。记录术后24小时病人PONV发生率。结果：C组、P0．5组、P1．0组和P1．5；组四组患者术后24h内PONV总发生率分别为65％、60％、20％和15％，在24h观察期内，P1.0组和P1．5组患者PONV预防明显好于C组、P0.5组（P〈0.05），而P1.0组和P1.5组间术后24h内PONV总发生率差异无统计学意义。结论：异丙酚1．0和1．5mg·K^-1·h^-1输注都能明显减少腹腔镜胆囊切除术后恶心的发生率，但增加剂量至1．5mg·Kg^-1·h^-1并不会增加镇吐效能，因此异丙酚1．5mg·Kg^-1·h^-1输注是预防腹腔镜胆囊切除术后病人恶心呕吐发生的最佳剂量。

Optimum dose of propofol for prevention of emetic episodes after laparoscopic cholecystectomy

Objective： To estimate the optimum dose of propofol for reducing emetic episodes after laparoscopic cholecystectomy. Methods：80 patients were divided into 4 groups received either placebo or three different deses（0.5mg·Kg^-1·h^-1, 1.0mg·Kg^-1·h^-1,1.5mg·Kg^-1, h^-1 ）of propofol immediately after induction of anesthesia. Emetic episodes were recorded and safety assessments were performed during 0-24 hours after the surgry. Results： The incidence of patients with emetic episodes during 0-24 hours after surgry was 60% with 0.5mg·Kg^-1·h^-1（ P 〉 0.05） ,20% with 1.0mg·Kg^-1·h^-1（ P 〈 0.01） and 15% with 1.5mg·Kg^-1·h^-1（ P 〈 0.01）of pmpofol compared with placebo（65% ）. Conduslorla： We conclude that propofol 1.0mg·Kg^-1·h^-1 is the optimum dose for reducing emetie symptoms after laparoscopie eholecystectomy. Increasing the dose to 1.5mg·Kg^-1·h^-1 provides no further benefit.