比较依托咪酯与丙泊酚诱导全身麻醉在剖宫产术中的应用

发布时间：2018-06-29 18:38

本文选题：剖宫产术 + 丙泊酚　；参考：《中国现代医学杂志》2017年08期

【摘要】：目的比较依托咪酯与丙泊酚对全身麻醉剖宫产产妇血流动力学、意识和新生儿的影响。方法选取70例全身麻醉下行剖宫产产妇,随机分为2组,即丙泊酚组(35例):诱导剂量2 mg/kg,依托咪酯组(35例):诱导量0.3 mg/kg。记录所有产妇麻醉诱导前(T0)、诱导后1 min(T_1)、2 min(T_2)及5 min(T_3)时的心率(HR)、收缩压(SAP)、舒张压(DAP)、平均动脉压(MAP)以及血氧饱和度(SpO)_2。记录并分析术前、术后(前10 min,1次/min,之后1次/5 min)、切皮、子宫切开、胎儿娩出、子宫缝合、皮肤缝合、睁眼和拔管时的脑电双频指数(BIS)等数据。结果两组产妇基线资料差异无统计学意义。T_2及T_3时,依托咪酯组的SAP、DAP及MAP均高于丙泊酚组(P0.05)。麻醉诱导后1~8 min以及切皮时、切子宫时、胎儿娩出时及气管拔管时,依托咪酯组的BIS值均低于丙泊酚组(P0.05)。两组产妇手术时间、脐静脉血气值、新生儿APGAR评分、术后血流动力学、止痛效果及不良反应等差异均无统计学意义(P0.05)。但依托咪酯组产妇复苏时间短于丙泊酚组,差异有统计学意义(P=0.036)。结论依托咪酯较丙泊酚诱导全身麻醉对剖宫产产妇的血流动力学影响更小,安全性高,更适合剖宫产手术的全麻诱导,值得临床推广应用。
[Abstract]:Objective to compare the effect of etomidate and propofol on the hemodynamics, consciousness and newborn of cesarean section of general anesthesia. Methods 70 cases of cesarean section were randomly divided into 2 groups, that is, propofol group (35 cases): the induced dosage of 2 mg/kg, etomidate group (35 cases): the induction amount of 0.3 mg/kg. before the induction of all maternal anesthesia induction (T0 ) the heart rate (HR), systolic pressure (SAP), diastolic pressure (DAP), mean arterial pressure (MAP) and oxygen saturation (SpO) _2. records were induced after 1 min (T_1), 2 min (T_2) and 5 min (T_3), and preoperative (10, 1, 1 times), skin incision, hysterotomy, fetal delivery, uterine suture, skin suture, open eyes and extubation Results the difference between the two groups of two groups of maternal baseline data was not statistically significant.T_2 and T_3, the SAP, DAP and MAP in the etomidate group were higher than the propofol group (P0.05). The BIS values of the ietomidate group were lower than the propofol group (P0.05). The two groups were lower than the propofol group (P0.05) when the uterus was cut and the uterus was cut, the fetus was delivered and the trachea was extubate. There was no significant difference in the operation time, the umbilical vein blood gas value, the neonatal APGAR score, the postoperative hemodynamics, the analgesic effect and the adverse reaction (P0.05). However, the time of resuscitation in the etomidate group was shorter than that in the propofol group (P=0.036). Conclusion etomidate was compared with propofol induced general anesthesia for cesarean section. The hemodynamic effect is smaller, the safety is high, and it is more suitable for the induction of general anesthesia in cesarean section. It is worthy of clinical application.
【作者单位】：湖北省武汉市xZ口区普爱医院西院麻醉科;
【分类号】：R614.2

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