不同剂量丙泊酚对儿童麻醉深度、血流动力学以及应激反应的影响

发布时间：2018-06-22 23:20

本文选题：儿童麻醉 + 丙泊酚　；参考：《医学综述》2016年02期

【摘要】：目的探讨不同剂量丙泊酚对儿童麻醉深度、血流动力学以及应激反应的影响。方法选择2013年4月至2014年6月在上海交通大学医学院附属上海儿童医学中心接受开腹手术治疗的75例患儿为研究对象,采用随机数字表法分为A组、B组和C组,各25例。3组患儿应用不同剂量的丙泊酚予以麻醉,A组起始剂量为10 mg/(kg·h),20 min后减少至8 mg/(kg·h),40 min后减少至6 mg/(kg·h),并维持该剂量至缝皮;B组起始剂量为15 mg/(kg·h),20 min后减少至10 mg/(kg·h),40 min后减少至8 mg/(kg·h),并维持该剂量至缝皮;C组起始剂量为20 mg/(kg·h),20 min后减少至15 mg/(kg·h),40 min后减少至10 mg/(kg·h),并维持该剂量至缝皮。观察、比较3组患儿的麻醉深度、血流动力学以及应激反应情况。结果各组患儿麻醉诱导前、插管前1 min、插管后1 min、切皮前1 min、切皮后1 min、手术探查时以及手术结束时的皮质醇、血糖变化情况差异有统计学意义(P0.05),A组、C组皮质醇波动较频繁,B组较平稳;3组患儿血糖均呈下降趋势,但B组在正常范围内;各组患儿皮质醇和血糖在组间、组间·不同时间点的交互作用比较差异有统计学意义(P0.05)。结论儿童全身麻醉手术中,15、10、8 mg/(kg·h)的丙泊酚在麻醉维持中具有重要作用,既能保证获得满意的麻醉深度,又能减轻血流动力学和应激反应方面的不良影响,具有重要的临床意义。
[Abstract]:Objective to investigate the effects of different doses of propofol on anesthetic depth, hemodynamics and stress response in children. Methods from April 2013 to June 2014, 75 children received open surgery in Shanghai Children's Medical Center, Shanghai Jiaotong University Medical College, and were randomly divided into two groups: group A, group B and group C. 25 children in each group were treated with propofol with different doses of propofol. The initial dose of propofol was 10 mg/ (kg h) / 20 min, then decreased to 8 mg/ (kg h) / 40 min and decreased to 6 mg/ (kg h),. The initial dose of propofol in group B was 15 mg/ (kg h) / 20 min and then decreased to 10 mg/ (kg h) / 40 min Then it was reduced to 8 mg/ (kg h), and maintained to the initial dose of 20 mg/ (kg h) / 20 min for group C, then decreased to 15 mg/ (kg h) / 40 min and decreased to 10 mg/ (kg h), and maintained to the suture skin. The anesthetic depth, hemodynamics and stress response of the three groups were compared. Results before anesthesia induction, 1 minute before intubation, 1 minute after intubation, 1 minute before skin incision, 1 minute after incision, and 1 minute after operation, cortisol was detected during operation and at the end of operation. The changes of blood glucose in group A were significantly different (P0.05) cortisol fluctuated more frequently in group A than that in group B, but the blood glucose in group B was in the normal range, and cortisol and blood sugar in each group were in the same group. There were significant differences in the interaction between groups at different time points (P0.05). Conclusion propofol of 1510 ~ (8 mg/ (kg h) in children's general anesthesia operation plays an important role in maintenance of anesthesia, which can not only ensure satisfactory depth of anesthesia, but also alleviate adverse effects of hemodynamics and stress reaction, and has important clinical significance.
【作者单位】：上海交通大学医学院附属上海儿童医学中心麻醉科;
【分类号】：R726.1

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