摘要
目的观察亚睡眠剂量丙泊酚对止血带引起的缺血再灌注损伤的影响。方法选取我院收治的84例需行止血带加压止血的骨科下肢手术患者作为研究对象,随机分为两组。对照组(n=41)采用常规硬膜外麻醉,观察组(n=43)在行硬膜外麻醉后,持续输入亚睡眠剂量丙泊酚[0.5mg/(kg·h)]。比较两组患者在止血带充气前(T0),止血带开放即刻(T1),止血带开放15min(T2)、止血带开放30min(T3)时的心率(HR)、收缩压(SBP)、舒张压(DBP)、脉搏氧饱和度(Sp O2),并抽取静脉血测定乳酸脱氢酶(LDH)、肌酸激酶(CK)和丙二醛(MDA)的含量。结果两组患者各时间点HR、SBP、DBP、Sp O2比较,差异无统计学意义(P>0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。观察组患者T1、T2、T3时刻LDH、CK、MDA水平均低于同时期对照组患者,差异有统计学意义(P<0.05)。结论亚睡眠剂量丙泊酚可有效减少患者由止血带引起的氧化应激反应,减轻缺血再灌注损伤,并具有较好的安全性。
Objective To observe the effect of subsleep dose of propofol on tourniquet induced ischemia-reperfusion injury.Methods Eighty-four cases of lower extremity surgery in department of orthopedics who need tourniquet to stop bleeding were selected as the research objects.They were randomly divided into 2 groups.The control group(n=41)received routine epidural anesthesia,and the observation group(n=43)received continuous subsleep doses of propofol(0.5mg/kg/h)after epidural anesthesia.The heart rate(HR),systolic pressure(SBP),diastolic pressure(DBP)and pulse oxygen saturation(SpO2)were compared between the two groups before the tourniquet was inflated(T0),the tourniquet opened immediately(T1),15min after the tourniquet opened(T2),and 30min after the tourniquet opened(T3).The contents of lactate dehydrogenase(LDH),creatine kinase(CK)and malondialdehyde(MDA)were extracted from venous blood and measured.Results There were no significant differences in HR,SBP,DBP and SpO2 between the two groups at all time points(P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The levels of LDH,CK and MDA at T1,T2 and T3 in the observation group were lower than those in the control group at the same time,the difference was statistically significant(P<0.05).Conclusion Subsleep dose of propofol can effectively reduce the oxidative stress caused by tourniquet,alleviate ischemia reperfusion injury,and has better safety.
作者
郭秋娥
李丽梅
段军杰
GUO Qiue;LI Limei;DUAN Junjie(Department of Anesthesiology,Shenzhen Longgang Central Hospital,Guangdong,Shenzhen 518116,China)
出处
《中国医药科学》
2018年第7期166-169,共4页
China Medicine And Pharmacy
关键词
丙泊酚
亚睡眠剂量
缺血再灌注损伤
氧化应激反应
Propofol
Subsleep dose
Ischemia-reperfusion injury
Oxidative stress reaction
