【摘要】 目的观察不同速度泵注小剂量丙泊酚对静脉全麻诱导期血压的影响,探寻静脉全麻诱导时丙泊酚的适宜注射速度与剂量。方法选择2017年9~12月我院拟行静脉全麻诱导的患者60例,ASA分级Ⅰ~Ⅱ级。采用力月西、舒芬太尼、丙泊酚、罗库溴铵等药复合,循序静注诱导。随机分为两组,Ⅰ组丙泊酚以2 mg/(kg·min)速度匀速泵注,Ⅱ组丙泊酚以0.5mg/(kg·min)速度匀速泵注。分别观察并记录患者诱导前、诱导后1 min、5 min、10 min时血压、心率数值,诱导期监测BIS值评价全麻诱导深度。结果Ⅰ组全麻诱导后1 min[SBP:(117.2±7.6)mm Hg,DBP(74.4±22.1)mm Hg]血压即较基础值[SBP:(132.3±8.5)mm Hg,DBP(87.7±14.4)mm Hg]开始大幅度下降,5 min[SBP:(107.5±18.6)mm Hg,DBP(67.5±16.2)mm Hg]、10 min血压[SBP:(106.2±14.5)mm Hg,DBP(67.0±15.9)mm Hg]与基础值比较均有非常显著差异(P<0.01)。Ⅱ组全麻诱导后血压平稳,与基础血压比较无显著差异(P>0.05)。Ⅰ组诱导期不同时间点血压下降幅度[SBP:(24.9±6.3)mm Hg,(34.5±9.9)mm Hg,(35.4±5.6)mm Hg;DBP:(13.5±2.4)mm Hg,(20.3±5.7)mm Hg,(20.6±5.3)mm Hg]与Ⅱ组比较有非常显著差异(P<0.01)。结论 0.5 mg/(kg·min)注速匀速泵注丙泊酚用于静脉全麻诱导,血压波动小。更多还原

【Abstract】 Objective To observe the effect of low-dose propofol at different speeds on the blood pressure during the induction period of intravenous general anesthesia, in order to explore the suitable injection speed and dose of propofol during the induction of intravenous anesthesia. Methods 60 patients admitted in our hospital for intravenous general anesthesia induction with ASA grades Ⅰ-Ⅱ from September to December 2017 were selected. Midazolam, sufentanil,propofol, rocuronium, and other drugs were combined and used for induction by sequential intravenous injection. Participants were randomly divided into two groups. Propofol in group Ⅰ was pumped at a uniform rate of 2 mg/(kg·min),and propofol in group Ⅱ was pumped at a rate of 0.5 mg/(kg·min). We observed and recorded the blood pressure and heart rate values before induction, 1 minute, 5 minutes, and 10 minutes after induction, and monitored the BIS value during the induction period to assess the depth of induction of general anesthesia. Results Blood pressure at 1 minute after general anesthesia induction in group Ⅰ [SBP(117.2 ±7.6)mm Hg, DBP(74.4 ±22.1)mm Hg]decreased significantly compared with the baseline [SBP(132.3 ±8.5)mm Hg, DBP(87.7 ±14.4)mm Hg], and 5-minutes blood pressure [SBP( 107. 5 ± 18. 6) mm Hg, DBP( 67. 5 ± 16.2)mm Hg], 10-minute blood pressure [SBP(106.2 ±14.5)mm Hg, DBP(67.0 ±15.9)mm Hg]were all significantly different from the baseline(P<0.01). Group Ⅱ had stable blood pressure after induction of general anesthesia and there was no significant difference from the baseline blood pressure(P>0.05). The decreases in blood pressure at different time points in the induction period of group Ⅰ [SBP(24.9 ±6.3)mm Hg,(34.5 ±9.9)mm Hg,(35.4±5.6)mm Hg; DBP(13.5±2.4)mm Hg,(20.3±5.7)mm Hg,(20.6±5.3) mm Hg] were significantly different compared with Group Ⅱ(P<0.01). Conclusion Propofol at 0.5 mg/(kg·min) injection rate for intravenous general anesthesia has little fluctuation of blood pressure.更多还原