【摘要】 目的探讨不同剂量丙泊酚对患儿麻醉深度、应激反应、血流动力学的影响。方法选择下腹部手术患儿60例的临床资料进行回顾性分析,根据丙泊酚的使用剂量分为3组。第1组21例,丙泊酚起始维持剂量10 mg/(kg·h),后每隔20min减量2 mg/(kg·h),以6 mg/(kg·h)维持到缝皮;第2组19例,丙泊酚初始维持剂量15 mg/(kg·h),20 min后减量为10 mg/(kg·h),40 min后减量为8 mg/(kg·h)维持到缝皮;第3组20例,丙泊酚初始维持剂量20 mg/(kg·h),后每隔20 min减量5 mg/(kg·h),以10 mg/(kg·h)维持到缝皮。评价3组患儿不同时间点BIS、血流动力学以及应激反应。结果第2组和第3组在各时间点麻醉深度大于第1组(P<0.01)。第3组对MAP和心率有明显的抑制作用。第1组的应激反应较第2组和第3组强(P<0.05)。结论丙泊酚用于儿童全麻按照15 mg/(kg·h)、10 mg/(kg·h)、8 mg/(kg·h)维持麻醉,患儿既可以达到较满意的麻醉深度,并且对应激反应和血流动力学的影响较轻。更多还原

【Abstract】 Objective To discuss effect of different doses of propofol for children anesthesia on depth, stress response and hemodynamic. Methods Clinical data of 60 cases with abdominal surgery were retrospectively analyzed. All cases were divided into 3 groups according to different doses of propofol. Group 1 of 21 cases, initial maintenance dose of propofol was 10 mg/(kg·h), then every 20 minutes reduced 2 mg/(kg·h), with 6 mg/(kg·h) maintaining to sew leather;Group 2 of 19 cases, initial maintenance dose of propofol was 15 mg/(kg·h) after 20 minutes reduced to 10 mg/(kg·h),after 40 minutes reduced to 8 mg/(kg·h) and maintained to sew leather; Group 3 of 20 cases, initial maintenance dose of propofol was 20 mg/(kg·h), then every 20 minutes reduced 5 mg/(kg·h), with 10 mg/(kg·h) maintaining to sew leather. BIS, hemodynamic and stress response of three groups in different time were compared. Results The depth of anesthesia of group 2 and group 3 at each time point were greater than in group 1(P<0.01). MAP and heart rate of group 3 were significantly inhibited. Stress response in group 1 was more intensity than group 2 and group 3(P<0.05).Conclusion Propofol anesthesia for children with 15 mg/(kg·h), 10 mg/(kg·h), 8 mg/(kg·h) to maintain anesthesia,children can achieve satisfactory depth of anesthesia, and the impact on the stress response and hemodynamic are lighter.更多还原