【摘要】 目的观察丙泊酚不同输注方式对麻醉诱导阶段血浆皮质醇(Cor)、催乳素(PRL)的影响。方法30例择期全麻手术患者,随机分为G1组(国人参数组)、G2组(Tackley参数组)、G3组(BET组),每组10例。分别于诱导前(T0)、轻拍三角肌不应即刻(T1)、气管插管过声门即刻(T2)、插管后3min(T3)、5min(T4)、10min(T5)记录HR、MAP并采集动脉血标本以测定血浆Cor、PRL。结果三组麻醉诱导期间HR、MAP随时间变化差异都无显著意义。三组麻醉诱导阶段血浆Cor、PRL的浓度差异有极显著意义(P<0.01)。在T1时点,三组血浆Cor浓度有轻度下降,而PRL的浓度轻度增加。插管时,三组血浆Cor、PRL浓度均上升,以G3组最显著。结论G1组对应激反应的控制优于G2、G3组。麻醉诱导期间血浆Cor、PRL的浓度变化可用于判定镇静深度。更多还原

【Abstract】 Objective To study the influence of different propofol target-controlled infusion （TCI） system on plasma concentration of cortisol（Cor） and prolactin（PRL） during induction of anesthesia. Methods Thirty ASA class Ⅰ or Ⅱ patients （17 male,13 female,20-60years of age,weighted 45-80kg）,scheduled for surgery under general anesthesia were included in this study.According to the ways of propofol infusion with different TCI system during induction of anesthesia,the patients were randomly divided into three groups with 10 cases each. The chinese TCI data were used in group G₁,Tackley in group G₂ and BET in group G₃. MAP and HR were continuously monitored. Blood samples were taken before induction of anesthesia （T₀,baseline）,after no response to prodding （T₁）,during intubation （T₂）,at 3min （T₃）,5min（T₄）,and 10min （T₅） after intubation for the measurements of plasma Cor and PRL.Results During induction,the changes of HR and MAP at all time points had no significant difference among three groups,which of Cor and PRL had a significant difference among three groups（P<0.01）. At the endpoint of T₁,the concentration of PRL was slightly increased. However,the concentration of PRL was decreased in three groups. The level of Cor and PRL was elevated at the time of intubation in three groups,which was marked in group G₃. Conclusion The three TCI systems have been shown to blunt the hemodynamic and stress response to laryngoscopy.The TCI system used in group G₃ was superior to the others in group G₁ and G₂. The plasma concentration of Cor and PRL is an useful indicator to predict the depth of sedation.更多还原