摘要
目的比较异丙酚靶控输注(TCI)和人工持续输注(CI)用于宫腔镜手术的麻醉效果、用药剂量以及对患者呼吸和循环功能的影响。方法选择60例行宫腔镜手术的患者,美国麻醉学会(ASA)分级Ⅰ～Ⅱ级,随机均分为TCI组和CI组。TCI组设定初始靶浓度为2.0μg/ml,随后根据手术进程调节靶浓度,扩宫口时将靶浓度升至6.0μg/ml,以后降至4.5μg/ml,术毕前调至2.0～3.0μg/ml;CI组设定初始剂量为2.0～2.5mg/ml,而后微泵维持(7.0ml·kg-1·h-1),术中根据患者体动反应追加药量;两组均在手术结束时停止给药。记录两组患者睫毛反射消失时间、苏醒时间、用药量以及麻醉前、后的血压、心率、脉搏血氧饱和度(SPO2)变化。结果TCI组睫毛反射消失时间明显长于CI组(P<0.05),但苏醒时间明显短于CI组(P<0.05)。两组用药量的差异无显著性(P>0.05)。CI组血压、心率下降者所占比例明显高于TCI组(P<0.05)。两组均有SPO2<90%的患者,CI组往往发生在诱导和追加药量时,而TCI组则发生在扩宫颈口后。结论对于宫腔镜手术而言,TCI法较CI法具有更好的可控性和安全性。
Objective To compare the anesthetic efficacy, dosages and effects of propofol on respiratory and cardiovascular functions between target-controlled infusion (TCI) and continuous infusion (CI) during hysteroscopy. Methods Sixty ASA Ⅰ-Ⅱ patients undergone hysteroscopy were randomly assigned to one of the following two groups, i.e. TCI group (n=30) and CI group (n=30). In TCI group, the initial effect-site target concentration of propofol was set at 2.0 μg/ml, then adjusted according to the operating progress. The target concentration was set at 6.0 μg/ml for dilating the cervices, then the infused rate decreased to 4.5 μg/ml and returned to 2.0-3.0 μg/ml before the completion of operation. In CI group, propofol was given at a bolus injection of 2.0-2.5 μg/ml intravenously, followed by continuous infusion (7 ml·kg -1·h -1), the dosage was increased according to the body movement response. Both groups ceased to be infused by the end of the operation and the time of disappearance of eyelash reflex, the recovery time and the total dose of propofol were recorded simultaneously. The blood pressure, heart rate and SPO_2 were monitored during the operation.Results The time of disappearance of eyelash reflex in TCI group was longer than that in the CI group, but the recovery time was significantly shorter in TCI group (P< 0.05). There was no significant difference of propofol requirement between the two groups (P<0.05); The rate of blood pressure fall in CI group was greater than that in TCI group (P<0.05). There were some patients with SPO_2<90% in both groups, including SPO_2 less than 90% in TCI group occurred when cervices were dilated, but in CI group this occurred during induction and with addition of propofol.Conclusion In comparison with continuous infusion of propofol during hysteroscopy, the target-controlled infusion provides better control and safety.
出处
《上海医学》
CAS
CSCD
北大核心
2005年第5期399-401,共3页
Shanghai Medical Journal
关键词
异丙酚
靶控输注
人工持续输注
宫腔镜手术
麻醉处理
Target-controlled infusion with propofol
Propofol continuous infusion
Hysteroscopy
