摘要
目的 :比较持续靶控输注 (TCI)和人工控制输注丙泊酚全凭静脉麻醉诱导和维持对血流动力学、糖代谢的改变。方法 :5 2例腹腔镜择期手术患者 ,ASAⅠ～Ⅱ级 ,随机分为靶控 (T)组和人工控制输注 (R)组 ,每组 2 6例。T组靶控输注丙泊酚 ,靶浓度设定为 4 μg/ml,诱导和维持连续输注 ;R组泵注 1%丙泊酚 ,负荷剂量 2mg/kg ,再以 6mg/kg·h-1连续输注。记录术前至术毕不同时点的血压、心率、BIS和血糖值。结果 :与基础值对比 ,诱导后行气管插管 ,两组的收缩压、舒张压波动不明显 ,CO2 气腹时有显著上升 (P <0 .0 5 )。T组可较快恢复正常 ,R组需加大丙泊酚的输注量 ,但心率呈进行性减慢 ,大多需注射阿托品治疗 ,与T组比较呈显著差异 (P <0 .0 5 )。血糖在气管插管、手术及CO2 气腹后逐渐上升 (P <0 .0 5 )。结论
Objective:To compare the change of propofol target controlled infusion with manual on hemodynamics and glycometabolism.Methods:Fifty two patients(ASA grade Ⅰ Ⅱ)scheduled for gynecologic laparoscopy were divided into two groups with 26 cases each.The anestheia was induced and maintained by TCI with propofol which target concentration was 4 μg/ml(Group T)and by manual controlled infusion with propofol(Group R).Its load was 2 mg/kg and then continue to infusion 6 mg/kg·h -1 .SBP?DBP?HR?BIS and blood glucose levels were determined at the five time points.Results:Compare with the baseline,SBP?DBP undulation were not significantly after intubation in two groups. But increased significantly after CO 2 pneumoperitoneum, P < 0.05 .The group T returned to normal quickly,but group R need more infusion dose of propofol.However,HR was slowing in group R.Most of the patients needed atropine treatment.There was a significant different between group T and group R( P <0.05).Glucose level was increased significantly after operation and CO 2 pneumoperitoneum( P <0.05).Conclusion:Target controlled infusion of propofol in total intrvenous anesthesia can maintain stable cardiovascular function.
出处
《实用临床医学（江西）》
CAS
2003年第6期20-22,共3页
Practical Clinical Medicine
