摘要
目的比较人工流产术患者不同效应室靶浓度异丙酚的麻醉效果。方法拟行人工流产术患者90例,年龄18～30岁,ASAI级,孕周为6～10周。随机分为3组(P_(4.5)、P_(5.0)、P_(5.5)组),每组30例。异丙酚效应室靶浓度分别为4.5、5.0、5.5μg/mL。设定异丙酚初始血浆靶浓度4.0μg/mL,靶控输注分步骤进行,每步间隔20 s,目标血浆靶浓度6.0μg/mL。静脉注射芬太尼1.0μg/kg后开始靶控输注异丙酚,分别于效应室靶浓度达到4.5、5.0、5.5μg/mL时,开始行人工流产术。记录麻醉诱导前(基础状态)、诱导后1 min(T_1)、3 min(T_2)、置入窥器(T_3)、扩宫颈(T_4)、吸宫(T_5)、术毕(T_6)、患者睁眼(T_7)和清醒(T_8)时的MAP、HR、SpO_2,记录异丙酚总用量、SpO_2最低值、麻醉诱导时间、维持时间和苏醒时间。结果3组病例MAP、HR和SpO_2波动均在正常范围,3组患者一般资料比较差异无统计学意义(P>0.05);与P_(4.5)组比较,P_(5.0)组、P_(5.5)组麻醉诱导时间均延长,异丙酚麻醉诱导量增加(P<0.01);与P_(5.5)组比较,P_(5.0)组麻醉诱导时间、苏醒时间均缩短,异丙酚麻醉诱导量减少(P<0.01)。P_(5.5)组麻醉效果优于P_(4.5)、P_(5.0)组(P<0.05),但P_(5.5)组呼吸抑制发生率明显高于P_(4.5)、P_(5.0)组(P<0.01)。结论异丙酚效应室靶浓度达到5.0μg/mL时,行人工流产术麻醉效果可靠,安全性高。
Objective To compare the efficacy of different target effect-site concentrations of propofol given by target-controlled infusion（TCI） for patients undergoing dilatation and curettage（D＆C）.Methods Ninety ASAI 6～10 wk pregnant nulliparae aged 18～30yr undergoing D＆C were randomly allocated into 3 groups based on the target effect-site propofol concentration by TCI（n= 30）：group I 4.5μg/mL,groupⅡ5.0μg/mL, groupⅢ5.5μg/mL.Anestheaia was indued with fentanyl 1.0μg/kg and propofol given by TCI.The initial target plasma propofol concentration was set at 4.0μg/mL and then gradually increased.Induced abortion was performed at the target effect-site concentrations 4.5,5.0 and 5.5μg/mL respectively in the 3 groups.MAP,HR and SpO_2 were continuously monitored and recorded before（baseline）,and after induction of anesthesia,and the main step of the operation.The duration of induction and maintenance of anethesia,total amount of propofol infused and the lowest SpO2 value were recorded.Limb move.ment was used to evaluate the efficacy of propofol TCI among the three groups.Results The induction time was significantly longer in groupⅢ（6.54±0.17）min than in groupⅡ（5.71±0.30）min and groupⅠ（5.49±0.23）min.There were no significant difference in the total amount of propofol infused among the three groups.The lowest SpO2 was significantly higher in groupⅢ（88±7.0）%than in groupⅡ（93±6）%and groupⅠ（94±4）%.The frequency of limb movement was significantly higher in groupⅠthan in groupⅢand in groupⅡ.Conclusion Target effect-site propofol concentration 5.0μg/ mL might be safe and effective for patients undergoing dilatation and curettage（D＆C）.
出处
《黑龙江医学》
2010年第1期27-29,共3页
Heilongjiang Medical Journal
关键词
异丙酚
流产
人工
药物释放系统
剂量效应关系
Propofol
Abortion, Induced
Dose - response relationship, Drug
Drug delivery systems
