| | | 丙泊酚不同诱导方式全凭静脉麻醉
| | 毕业论文
作者：丁倩，柴伟，赵晖，杨永慧，张贵和
【关键词】 麻醉
Constant infusion of propofol in different induction modes for total intravenous anesthesia
【Abstract】 AIM: To observe the hemodynamic changes and palinesthesia in constant infusion of propofol in different induction modes for total intravenous anesthesia (TIVA), and to investigate if the hemodynamic changes and palinesthesia are stable in general anesthesia and find out the best way of induction. METHODS: Sixty operated patients who were anesthetized by constant infusion of propofol according to the 975 strategy, were randomly divided into 3 groups: 1 min induction (group A), 2 min induction (group B) and 4 min induction (group C). Blood pressure (BP), heart rate (HR), pulse oxygen saturation (SpO2) and bispectral index (BIS) were monitored during the whole process of anesthesia. RESULTS: All groups induced and maintained with constant infusion of propofol got a satisfied general anesthesia. BP and BIS among groups had a significant difference during anesthesia induction（P<0.05）. BP and BIS changed steadily in group C. Hemodynamic changes, SpO2 and BIS had no significant difference among groups during anesthesia maintenance（P>0.05）. All the patients came around quickly and steadily (P>0.05). CONCLUSION: Constant infusion of propofol for TIVA could realize induction and maintenance, with quick and steady palinesthesia. Fourminute induction with constant infusion of propofol made hemodynamics steady in induction.
【Keywords】 anesthesia; infusion; propofol; induction
【摘要】 目的毕业论文：观察不同诱导方式恒速输注丙泊酚全凭静脉麻醉(TIVA)，诱导及维持阶段血流动力学变化及苏醒期情况，了解恒速输注丙泊酚TIVA是否能够达到全麻要求并维持血流动力学稳定，同时找出合适诱导方式. 方法：60例全麻手术患者，均使用丙泊酚恒速输注诱导及维持，随机分为975恒速输注方案1 min诱导（A）组、2 min诱导（B）组和4 min诱导（C）组，监测麻醉前、诱导和维持期及停药后血压（BP），心率（HR），脉搏氧饱合度（SpO2）及脑电图双频谱指数（BIS）. 结果：三组在诱导及维持期均能达到满意的毕业论文全麻要求，诱导期间3组BP，BIS变化差异有统计学意义（P<0.05），其中C组BP及BIS变化平稳，维持期3组所有监测指标差异无统计学意义（P>0.05），3组患者均迅速、平稳苏醒，差异无统计学意义(P>0.05). 结论：恒速输注丙泊酚TIVA可满足全麻诱导及维持的需求，且苏醒迅速、平稳. 其中使用4 min诱导方式诱导期血流动力学平稳.
【关键词】 麻醉；输注；丙泊酚；诱导
0引言
近年来，丙泊酚因具有起效快、无呼吸道刺激、苏醒迅速平稳及无麻醉药环境污染等优点，已广泛应用于临床. 目前主要用于全麻诱导，硬膜外麻醉辅助镇静，无痛人流，无痛胃镜等领域. 丙泊酚靶控输注(target controlled infusion, TCI)技术也越来越多地应用于腹腔镜等短时手术，充分体现出其优越性. 但由于我国经济条件的限制，许多地区及医院尚未配备TCI设备，使丙泊酚应用受到限制，本实验应用Trivatrainer软件模拟血药浓度为3.5 μg/mL的975恒速输注方案，采用随机对照方法比较不同诱导方式恒速输注丙泊酚在全麻诱导和维持中的差异，观察诱导、维持期血流动力学改变及术终麻醉恢复情况，以评价其在临床上推广的可行性.
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