丙泊酚不同输注方式用于甲状腺切除术中的比较研究.docVIP

丙泊酚不同输注方式用于甲状腺切除术中的比较研究 郭文义，赵嘉训 摘 要 目的比较持续靶控输注（TCI）和人工控制恒速输注丙泊酚全凭静脉麻醉诱导和维持对血流动力学、麻醉恢复情况的影响。方法 40 例择期行甲状腺切除手术患者,ASA Ⅰ～ Ⅱ级,随机分为靶控( T) 组和人工控制输注(R) 组,每组20 例。T组靶控输注丙泊酚,靶浓度设定为4μg/ ml ,诱导和维持连续输注;R 组泵注1 %丙泊酚,负荷剂量1.8 mg/ 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、心率和BIS值，并观察患者术后的麻醉恢复情况。结果与基础值对比,诱导后行气管插管,两组的HR波动较明显( P 0. 05)。T组MAP变化趋势较R组平稳。T组苏醒时间与R组比较明显缩短( P 0. 05)。PONV发生率与R组比较更低( P 0. 05)。结论 靶控输注丙泊酚全凭静脉麻醉比人工控制输注方式有心血管反应小、苏醒即时等优点，更适合于甲状腺手术中的应用。 关键词 丙泊酚；靶控输注；全凭静脉麻醉；甲状腺切除术 Comparative Study of Different Infusion Mode using Propofol in Patient Undergoing Thyreoidectomy Wenyi Guo, Shanxi Medical University,Shanxi 030001 Abstract Objective To compare the change of propofol target controlled infusion with manual on hemodynamics and anesthesia recovery situation. Methods Forty patients (ASA gradeⅠ~Ⅱ) scheduled for thyreoidectomy were randomly divided into target-controlled (T) group and the manual controlled infusion (R) group, with 20 cases each. The anestheia was induced and maintained by TCI with propofol which target concentration was 4μg/ ml ( Group T) and by manual controlled infusion with propofol ( Group R) . The group R load was 1.8mg/ kg and then continue to infusion 6 mg?kg- 1?h - 1. Record the MAP, HR and BIS at the five time points, and observe the postoperative anesthesia recovery information. Results: Compared with the baseline, the HR fluctuations in two groups was a significant different after induced and tracheal intubation (P＜0. 05). The MAP of group T was more smooth than the group R. The group T recovery time was significantly shorter than the group R (P＜0. 05). The incidence of PONV was lower than the R (P＜0. 05). Conclusion: Target-controlled infusion of propofol total intravenous anesthesia compared with manually controlled infusion methods is more suitable for the thyreoidectomy. Key words Propofol; TCI; TIVA; Thyreoidectomy 近年来，随着药代动力学的研究进展及电子技术在麻醉领域的应用，全凭静脉麻醉越来越受到关注[1]。本课题比较观察了丙泊酚靶控输注（TCI）和人工控制输注全凭静脉麻醉对甲状腺切除术患者血流动力学和术后恢复情况的影响，探讨TCI在甲状腺切除术麻醉中的优越性，为临床