摘要
目的观察依托咪酯和乐维静静脉麻醉对腹腔镜手术应激反应的影响。方法选择30例妇科行腹腔镜手术病人,随机分为两组,依托咪酯组(E组)给予0.2mg/kg诱导,然后以0.7mg/(kg·h)维持;乐维静组(L组)给与1mg/kg诱导,然后以4mg/(kg·h)维持。观察记录比较诱导前(T0)、诱导(T1)、插管(T2)、气腹后5mi(nT3)、手术结束(T4)以及术后24h(T5)的心率和平均动脉压。并于T0、T2、T3、T4、T5抽取肘静脉血测定血糖和皮质醇。结果两组患者血流动力学组间相比在插管和气腹时心率L组和E组相比心率有差异性(P<0.05),L组比E组心率升高、血压增高更明显;皮质醇组间相比,L组在术毕时明显升高,而E组较术前明显降低,组间相比差异有显著性(P<0.05);两组血糖在T4升高有统计学意义,组间无统计学差别。结论依托咪酯在一定程度上抑制患者的应激反应,而皮质醇水平在正常范围。
[Objective] To investigate the Effects of etomidate and propofol intravenous anesthesia on stress response in gynaeeologieal laparoseopia suregery. [Methods] Thirty ASA Ⅱ Patients undergoing gynaeeoiogieal laparoseopie suregery patients were randomly divided into two groups：propofol group （group P） and etomidate group （group E）, induction of anesthesia with propofol 1 mg/kg in group C and with etomidate 0.2 mg/kg ingroupE. Combine Midazolam 1 mg/kg fentanyl 5 ug/kg and atraeurium 0.6 mg/kg, maintenance with propofol 4 mg/（kg.h） in group P and etomidate 0.7 mg/（kg.h） in group E. all patient maintainee with fentanyl 2 ug/kg. [Result] HR and MAP were much higher at intubation and 5 min after pneumoperitomeum （P 〈0.05）, and there were significant difference between two groups, group L raise up more significant; the level of eortisol were increased in group L and were decrease in group E at the end of operation; the level of blood suger were increased at the end of operation, there were no difference between two groups. [Conclution] Etomidate decreases the stress response of patients undergoing gynaecological laparoscopia suregery.and the level of cortisol is at normal ranger.
出处
《中国医学工程》
2006年第5期536-537,540,共3页
China Medical Engineering
