全麻苏醒拔管期丙泊酚靶控输注对术后复苏影响.docVIP

全麻苏醒拔管期丙泊酚靶控输注对术后复苏影响 王瑛 王樱 陈宇 【摘要】 目的 观察全麻苏醒拔管期丙泊酚靶控输注（TCI）对术后复苏的影响。方法 择期行普外科手术患者50例，ASA I～11级，随机均分为丙泊酚组（P组）和生理盐水对照组（C组）。两组患者均接受丙泊酚、维库溴铵、芬太尼、复合吸入1.0％～2.0％七氟烷的全身麻醉。术毕时送至麻醉复苏室（PACU），P组患者TCI输注丙泊酚，血浆浓度为1ug／ml，C组TCI输注生理盐水作对照。观察苏醒期患者的平均动脉压（MAP）、HR、VT、RR及SpO2、呼吸恢复时间、睁眼时间和拔管时间。结果 P组患者在吸痰、拔管时MAP、HR无明显变化，C组则明显升高（P＜0.05）；两组患者VT、RR、SpO2、呼吸恢复、睁眼、拔管时间差异无显著意义。结论 TCI丙泊酚可抑制全麻苏醒拔管期的心血管反应，平稳苏醒，无明显呼吸抑制作用。 【关键词】 丙泊酚；气管拔管；术后；复苏 The effect of propofol given by target-controlled infusion on the postanesthesia recovery [Abstract] Objective To study the effect of propofol given by target-controlled infusion(TCl) on the postanesthesia recovery. Methods fifty ASA I～II female patients undergoing general surgery were randomly assigned into two groups with 30 cases each: group P and group C. A11 patients received a standard general anesthesia with propofol，vecuronium，fentanil，1.0％～2.0％ sevofiurane. At the end of surgery，propofol was given by TCI at a fixed plasma concent ration of l ug/ml in group. Saline placebo was given in group C．Mean arterial pressure(MAP)，heart rate (HR)，tidal Vo1ume(VT)，respiration rate(RR)，pulse oxygen saturation(SpO2)，the time of recovery of breathe，open eye and extubation was recorded. Results Propofot attenuated the increase in MAP and HR at sputum aspiration and extubation. There were no differences in VT，RR，SpO2，the time of recovery of breathe，open eyes and extubation. Conclusion Propofol given by TCI inhibits cardiovascular response to emergence from anesthesia and tracheal extubation and provided quicker emergence and earlier recover，and has little depression on respiration. [Keywords] Propofol；Extubation；Postanesthesia；Recovery 全麻苏醒期气管拔管时可引起血压剧增、心率增快等强烈的心血管反应，反应过度可引起心肌缺血、心率失常，过高的血压还可引起手术部位出血[1]。为了探讨预防或减轻气管拔管时引起心血管反应的有效治疗方法，本文观察靶控输注丙泊酚在气管拔管时对心血管反应预防的有效性及可行性。 资料与方法 一般资料 50例择期在全麻下行普外科手术患者，年龄23～45岁，体重45～65kg，ASA I～Ⅱ级。术前均无心血管疾病，心电图、肝肾功能及电解质正常。随机均分为丙泊酚组（P组）和生理盐水对照组（C组）。 麻醉方法 两组患者术前常规禁食8~12 h，术前30 min肌注阿托品0.5 mg、苯巴