丙泊酚靶控输注麻醉对上腹部手术患者血流动力学的安全性和有效性分析

目的：探讨丙泊酚靶控输注麻醉对上腹部手术患者血流动力学的影响。方法选取上腹部手术患者84例，随机分为两组，每组42例。观察组使用丙泊酚靶控输注进行麻醉，对照组使用七氟醚吸入进行麻醉。对麻醉诱导前（T0）、气管插管前（T1）、气管插管完成瞬间（T2）、切皮后5 min（T3）、手术开始后45 min（T4）患者的血流动力学指标进行记录，并观察患者的不良反应和术后恢复情况。结果观察组各时刻心率（HR）与T0时刻比较，差异无统计学意义（P〉0.05）；对照组T1时刻HR明显低于T0时刻， T2时刻明显高于T0时刻（P〈0.05）。观察组仅T1时刻平均动脉压（MAP）明显低于T0时刻（P〈0.05）；对照组T1时刻MAP明显低于T0时刻， T2、T3、T4时刻明显高于T0时刻（P〈0.05）；观察组仅T1时刻血氧饱和度（SpO2）明显低于T0时刻（P〈0.05），后迅速恢复正常；对照组T1、T2、T3、T4时刻SpO2虽逐渐升高，但明显低于T0时刻（P〈0.05）。观察组睁眼时间、拔管时间、定向力恢复时间明显短于对照组（P〈0.05）；观察组不良反应发生率7.14%明显低于对照组21.43%（P〈0.05）。结论丙泊酚靶控输注用于上腹部手术麻醉对血流动力学影响小，不良反应发生率低，是一种安全可靠的麻醉方法，值得推广应用。

Safety and effectiveness of target controlled infusion of propofol anesthesia on haemodynamics of patients with upper abdominal operation

Objective To investigate the effect of target controlled infusion of propofol anesthesia on haemodynamics of patients with upper abdominal operation. Methods Selection of 84 patients with abdominal operation who were randomly divided into observation group and control group, each group had 42 cases. The observation group using target controlled infusion of propofol anesthesia, the control group were anesthetized with sevoflurane inhalation. Indexes of hemodynamics about before induction of anesthesia （T0）, before tracheal intubation （T1）, tracheal intubation moment （T2）, 5 min after skin incision （T3）, 45 min after operation beginning （T4） were recorded, and the adverse reactions and postoperative recovery were observed.Results The observation group each time the heart rate （HR） compared with the T0moment, no significant difference （P〉0.05）;the control group at T1 HR was significantly lower than that of T0 moment, T2 moment was significantly higher than that of T0 moment （P〈0.05）. The observation group only T1 times the mean arterial pressure （MAP） was significantly lower than that of T0 moment （P〈0.05）;the control group at T1 MAP was significantly lower than that of T0moment, T2 moment, T3, T4 was significantly higher than that of T0 moment （P〈0.05）;to observe the oxygen saturation of blood group T1 only time （SpO2） was significantly lower than that in T0 time （P〈0.05）, and then quickly return to normal;the control group T1, T2, T3, T4 time of SpO2 gradually increased, but significantly lower than that of T0 moment （P〈0.05）. In the observation group time to eye opening, extubation time, recovery time shortened significantly compared with control group （P〈0.05）;the observation group the incidence of adverse reaction was 7.14%, significantly lower than the control group 21.43% （P〈0.05）.Conclusion Effects of target controlled infusion of propofol anesthesia in upper abdominal operation with small effects on hemodynamics, low incidence o