依托咪酯联合咪唑安定麻醉诱导对异位妊娠腹腔镜手术患者麻醉效果、血流动力学及应激反应的影响

Influence of the etomidate combined with the midazolam for anesthesia induction during laparoscopic surgery of the ectopic pregnancy of patients on their anesthesia effect,hemodynamics and stress response

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摘要目的:探究依托咪酯联合咪唑安定麻醉诱导对异位妊娠腹腔镜手术患者麻醉效果、血流动力学及应激反应的影响。方法:按简单随机化分组法将2021年10月-2023年10月本院行异位妊娠腹腔镜手术患者分为两组各55例,分别接受丙泊酚联合咪唑安定麻醉诱导(丙泊酚组)或依托咪酯联合咪唑安定麻醉诱导(依托咪酯组)。比较两组麻醉效果和不良反应发生,在麻醉前(T0)、诱导中(T1)、维持后10min(T2)、手术结束时(T3)血流动力学平均动脉压(MAP)、心率(HR)指标,应激反应指标皮质醇(Cor)、去甲肾上腺素(NE)和脑氧供需平衡指标[脑氧饱和度(ScO_(2))、脑电双频指数(BIS)]。结果:依托咪酯组麻醉起效时间(1.01±0.26 min)、苏醒时间(7.07±1.56 min)、自主呼吸恢复时间(5.34±1.01 min)均低于丙泊酚组(1.29±0.29 min、9.89±2.34 min、7.25±1.19 min),手术结束后两组不良反应总发生率(7.2%、10.8%)无差异(P>0.05)。MAP、HR、Cor、NE、ScO_(2)、BIS,T0时两组无差异(P>0.05);T1、T2、T3时,依托咪酯组的MAP、HR、Cor、NE均低于丙泊酚组,ScO_(2)均高于丙泊酚组(均P<0.05),但BIS两组无差异(P>0.05)。结论:依托咪酯联合咪唑安定麻醉诱导能够提高异位妊娠腹腔镜手术患者的麻醉效果,且对患者的血流动力学和脑氧供需平衡产生积极影响,可减轻手术应激反应、降低不良反应发生率。 Objective:To explore the influence of the etomidate combined with the midazolam for anesthesia induction during laparoscopic surgery of the ectopic pregnancy of patients on their anesthesia effect,hemodynamics and stress response.Methods:According to the simple randomized grouping method,110 patients who wanted laparoscopic surgery of the ectopic pregnancy in the hospital were divided into observation group and control group(55 cases in each group)from October 2021 to October 2023.The patients in the control group received the propofol combined with the midazolam for anesthesia induction,while the patients in the observation group adopted the etomidate combined with the midazolam for anesthesia induction.The anesthesia effect,the adverse reactions,and values of the hemodynamics indicators,such as the mean arterial pressure(MAP)and heart rate(HR),the levels of the stress response indicators,such as the cortisol(Cor)and norepinephrine(NE),and the cerebral oxygen supply-demand balance indicators,such as the cerebral oxygen saturation(ScO_(2))and bispectraldex(BIS)before anesthesia(T0),during induction(T1),at 10 min after maintenance(T2)and at the end of surgery(T3)of the patients were compared between the two groups.Results:The onset time of the anesthesia(1.01±0.26 min),the recovery time(7.07±1.56 min),the recovery time of spontaneous breathing(5.34±1.01 min)of the patients in the observation group were significantly lower than those(1.29±0.29 min,9.89±2.34 min and 7.25±1.19 min)of the patients in the control group.There was no significant difference in the total incidence of the adverse reactions(7.2%vs.10.8%)of the patients between the two groups(P>0.05).There were no significant differences in the values of MAP,HR,Cor,NE,ScO_(2) and BIS of the patients at T0 between the two groups(P>0.05).At T1,T2 and T3,the values of MAP and HR,and the levels of Cor and NE of the patients in the observation group were significantly lower than those of the patients in the control group,and the ScO_(2) value of the patients in the observation group was significantly higher than that of the patients in the control group(all P<0.05),but there was no significant difference in the BIS value of the patients between the two groups(P>0.05).Conclusion:The etomidate combined with the midazolam for anesthesia induction during the laparoscopic surgery of the ectopic pregnancy of the patients can enhance their anesthesia effect,and which also has the positive impact on the hemodynamics and cerebral oxygen supply-demand balance of the patients,and can relieve the surgical stress response and reduce the incidence of the adverse reactions of the patients.

作者自华芬陈莉 ZI Huafen;CHEN Li(The First Affiliated Hospital of Chengdu Medical College,Chengdu,Sichuan Province,610500)

机构地区成都医学院第一附属医院

出处《中国计划生育学杂志》 2025年第8期1787-1791,1796,共6页 Chinese Journal of Family Planning

关键词异位妊娠腹腔镜手术麻醉诱导依托咪酯咪唑安定麻醉效果血流动力学应激反应不良反应 Laparoscopic surgery of the ectopic pregnancy Anesthesia induction Etomidate Midazolam Anesthesia effect Hemodynamics Stress response Adverse reaction

分类号 R614 [医药卫生—麻醉学]