【摘要】 目的评价异丙酚分步效应室TCI诱导模式在妇科腹腔镜手术患者全麻诱导中应用的效果。方法选择择期全麻下行妇科腹腔镜手术患者40例,随机分为常规效应室TCI诱导组(Ⅰ组)和分步效应室TCI诱导组(Ⅱ组)。分别记录两组患者麻醉诱导开始前(T0)、意识消失时(T1)、气管插管前即刻(T2)及气管插管完成时(T3)患者平均动脉压、心率及麻醉深度状态指数值。记录起效时间(开始输注异丙酚到意识消失时间),异丙酚血浆峰浓度,插管完成时间(开始输注异丙酚到气管插管完成时间),插管完成时异丙酚用量。结果两组患者不同时间点平均动脉压和心率间差异均有统计学意义(F值分别为30.82和25.69,P<0.05),与T0时比较两组患者平均动脉压均于T1时出现降低(P<0.05),T2时达最低值(P<0.05),T3时恢复至T0水平(P>0.05);T1、T2时间点组间比较显示Ⅰ组平均动脉压低于Ⅱ组(P<0.05)。与T0时比较两组患者心率均于T1时出现降低(P<0.05),T3时恢复T0水平(P>0.05)。与Ⅰ组比较,Ⅱ组起效时间、插管完成时间显著延长(P<0.05),异丙酚血浆峰浓度明显降低(P<0.05),但两组气管插管完成时异丙酚用量间差异无统计学意义(P>0.05)。结论异丙酚分步效应室TCI诱导模式对血流动力学的影响较轻,可安全有效地应用于全麻诱导。更多还原

【Abstract】 Objective To investigate the effect of stepwise effect chamber target-controlled infusion(TCI) during general anaesthesia induction.Methods Forty patients,who underwent gynecologic laparoscopic surgery in general anesthesia,were randomly allocated into group Ⅰ(routine effect chamber TCI induction group) and group Ⅱ(stepwise effect chamber TCI induction group).Mean arterial pressure(MAP),heart rate(HR) and depth of anesthesia index were recorded before induction(T0),during awareness disappearance(T1),just before tracheal intubation(T2) and after(T3),respectively,in both groups.And Time of taking effect(the time from propofol infusion to consciousness loss),propofol peak serum concentration,time of intubation completion(from the beginning of propofol infusion to intubation completion) and the dosage of propofol during intubation were measured.Results There was significant difference in MAP and HR at different time points between 2 groups(F=30.82,25.69,respectively,P<0.05).When compared with level at T0,MAP decreased at T1(P<0.05),and reached the nadir at T2(P<0.05),and returned to T0 level at T3(P>0.05);Comparison between groups T1 and T2 showed that MAP was lower in group Ⅰ than in group Ⅱ(P<0.05).As compared with T0 level,HR decreased at T1(P<0.05),and returned to T0 level at T3 in 2 groups(P>0.05).When compared with group Ⅰ,time of taking effect and of intubation was significantly prolonged(P<0.05) and propofol peak serum concentration reduced in group Ⅱ(P<0.05),but there was not significant difference in propofol dosage during intubation between 2 groups(P>0.05).Conclusion Stepwise induction of effect chamber TCI,having less effect on hemodynamics,can be used safely and effectively in general anesthesia induction.更多还原