摘要
目的观察不同剂量丙泊酚对老年患者中潜伏期听觉诱发电位(MLAEP)及应激反应的影响。方法选择择期行上腹部手术的老年患者60例,年龄60～81岁,ASAⅠ～Ⅱ级,心功能1～2级。无内分泌疾患及听力障碍。随机分为3组,每组20例,A组为术中持续泵注丙泊酚4mg/(kg·h),B组泵注丙泊酚6mg/(kg·h),C组泵注丙泊酚8mg/(kg·h)。分别记录入室后(TO)、麻醉诱导后3min(T1)、插管后1 min(T2)、切皮后2 min(T3)、关腹后(T4)及拔管后(T5)各时间点的HR、MAP及MLAEP各波波幅及潜伏期。在上述各时间点观察血浆皮质醇(CORT)浓度的变化。结果三组患者给药后Pa、Nb的潜伏期延长,Pa/Na、Pa/Nb的波幅降低(P<0.05)。三组患者给药后Pa、Nb的潜伏期延长,Pa/Na、Pa/Nb的波幅降低(P<0.05)。组间比较:在T3、T4时刻,A组Pa、Nb比B、C两组潜伏期短,Pa/Na、Pa/Nb比B、C两组波幅长(P<0.05),B、C两组间差异无统计学意义(P>0.05)。在给药后T1时刻与T0比较CORT值降低,在T4、T5时比,T0升高,差异均有统计学意义(P<0.05);组间比较在T3、T4、T5时A与B、C比较CORT值均有统计学意义(P<0.05),而B、C之间比较差异均无统计学意义(P>0.05)。结论术中持续泵注丙泊酚6mg/(kg·h)可使老年患者达到足够的麻醉深度,并可抑制应激反应,各指标变化相对平稳。
Objective To explore the effects of different doses of propofol on the midlatency auditory evoked potentials and stress in elderly patients. Methods Sixty elderly patients（ ASA Ⅰ - Ⅱ , aged 60 - 81 years old, cardiac function Ⅰ - Ⅱ , and without endocrine disorders and heating impairment）scheduled for selective upper abdominal surgery with general anesthesia were randomly divided into three groups, each with 20 cases. Group A was, continuously pump- infused of propofol 4 mg/（kg·h）,group B of propofol 6 mg/（kg·h）,and group C of propofol 8 mg/ （kg·h） .HR, MAP.The wave amplitude and latency of MLAEP were recorded when patients entered the operating room（T0）, 3 rain after induction of anesthesia（T1 ）, 1 win after intubation（T2）, 2 win after skin incision（T3）, after abdominal Commissioner（T4）, and after extubation（T5）.Meanwhile, 3 ml blood samples were collected from the fight internal jugular vein at all time points, and plasma＇ s CORT concentrations were detected. Results Map at T1, T2, T3, T4 were slowly compared with previous administration（ P 〈 0.05）, and at T3, T4, T5, group A was higher than group C. Compared with B and C was significant differences at T3, and at T4, A and B had significant differences. After administration, three groups of patients＇ incubation period of Pa, Nb were extension, and the volatility of Pa/Na,Pa/Nb were significantly reduced（P 〈 0.05） .At T3,T4 moments,Pa,Nb,Na/Pa and Pa/Nb had statistical significant differences compared group A with B and C（ P 〈 0.05）,but B and C were meaningless（ P 〉 0.05）. CORT at T1 was lower than previous administration（ P 〈 0.05）, but at T4 and T5 was higher （ P 〈 0.05）. At T3, T4, the results of CORT in group A compared with B and C had significant differences（ P 〈 0.05）, but B and C had no statistical significant differences（ P 〉 0.05）. Conclusion Clinical dose of propofol can get adequately depth of anesthesia for elderly patients,and can inhibit the stress.When the dosage of propofol is to maintain the 6 mg/（kg·h） infusion, the index are relatively stability.
出处
《宁夏医学院学报》
2008年第5期567-569,共3页
Journal of Ningxia Medical College
基金
宁夏回族自治区教育厅科技攻关重点项目(2006年)
