【摘要】 目的通过对不同生理周期及绝经后的女性靶控输注(TCI)依托咪酯麻醉诱导时血浆靶浓度的测定,探讨孕酮水平对依托咪酯镇静作用的影响。方法选择全麻下行甲状腺次全切手术的35-40岁之间患者60例,按月经周期分为A组卵泡期女患者,B组黄体期女患者。术前检测孕酮水平,经静脉靶控输注(TCI)依托咪酯进行麻醉诱导,起始血浆浓度设为150ng/ml,达到预设浓度6min后,每次递增50ng/ml,直至患者意识消失(睫毛反射消失及OAA/S评分≤2分),且脑电双频指数(BIS)降至50。记录入室后、意识消失和BIS值为50时的依托咪酯血浆靶控浓度。结果 B组的孕酮水平均显著高于A组(P<0.05)。两组在各时间点HR、MAP、SPO2及BIS值的差异均无统计学意义(P>0.05)。患者在意识消失和BIS值为50时,与A组比较,B组的依托咪酯血浆靶浓度明显减少(P<0.05)。结论与卵泡期相比,黄体期依托咪酯麻醉诱导用量明显减少,可能与孕酮水平有关。更多还原

【Abstract】 Objectives To investigate effects of progesterone levels on sedative effects of etomidate by measuring target plasma concentration of etomidate at the time of anesthesia induction during different periods of female menstrual circle and after menopause. Methods 90 patients, aged 35 to 55, were selected to undergo subtotal thyroidectomy and were classified into three groups by admission number, including two divided groups according to menstrual circle: female patients in follicular phase(group A) and female patients in luteal phase(group B). Progesterone was tested before operation and etomidate was intravenously injected through target controlled infusion(TCI). The primary plasma concentration was 150ng/ml and when it went up to the default 6 minutes after, it rose by 50ng/ml until the patient had a loss of consciousness(Eyelash reflex disappeared and OAA/S score was less than or equal to 2 points) and BIS went down to 50. Record target plasma concentration of etomidate after entering into operation and at the time when conscious disappeared and BIS value was 50. Results The level of progesterone in group B was significantly higher than that in group B(P <0.05). The values of HR, MAP, SPO2 and BIS had no significant different at each time point. Compared with group A, when the patient lost his consciousness and BIS value was 50, target plasma concentration of etomidate in group B significantly decreased(P <0.05). Conclusions Compared with the induction dose of etomidate in follicular phase, it significantly decreased in luteal phase, which might have a relation with the level of progesterone.更多还原