BIS监测下丙泊酚靶控静脉麻醉与七氟醚麻醉效果比较

发布时间：2018-07-14 19:38

【摘要】：目的:比较BIS监测下丙泊酚靶控输注全凭静脉麻醉与七氟醚静吸复合麻醉两种方式下的腹腔镜下子宫切除手术患者麻醉效果。方法:46例择期腹腔镜下子宫切除患者,ASAI`II级,随机分为:丙泊酚靶控全凭静脉麻醉组(TCI组)和七氟醚静吸复合麻醉组(SD组),各23例。术中均监测BIS值(维持在40~60)。记录麻醉诱导前(T1)、手术开始30 min(T2)、术后1 h(T3)患者血压(BP)和心率(HR);记录术后自主呼吸恢复时间、睁眼时间、拔管时间;记录术中知晓发生率和术后24小时恶心呕吐(PONV)发生率。结果:TCI组与SD组患者BP和HR在T1、T2、T3各时间点比较差异均无统计学意义(P0.05);TCI组呼吸恢复时间、睁眼时间、拔管时间均早于SD组,差异有统计学意义(P0.05);两组患者均未发生术中知晓;但术后24小时PONV发生率TCI组明显低于SD组(P0.05)。结论:在BIS监测下,丙泊酚靶控全凭静脉麻醉与七氟醚静吸复合麻醉用于腔镜下子宫切除手术均能够维持术中患者血流动力学平稳,预防术中知晓,但全凭静脉麻醉较静吸复合麻醉患者术后恢复更快,术后24小时恶心呕吐发生率低。
[Abstract]:Objective: to compare the anesthetic effects of total intravenous anesthesia with propofol target-controlled infusion and sevoflurane combined anesthesia in patients undergoing laparoscopic hysterectomy under BIS monitoring. Methods 46 patients with elective laparoscopic hysterectomy were randomly divided into two groups: TCI group (TCI) and combined sevoflurane inhalation anesthesia group (SD group), 23 patients in each group were randomly divided into two groups: total intravenous anesthesia group (TCI group) and sevoflurane combined anesthesia group (SD group). BIS was monitored during operation (maintained at 40 ~ 60). The blood pressure (BP) and heart rate (HR) were recorded before anesthesia induction (T1), 30 min (T2), 1 h after operation (T3), the time of spontaneous respiratory recovery, eye opening and extubation, and the incidence of intraoperative awareness and nausea and vomiting (PONV) 24 hours after operation. Results there was no significant difference in BP and HR between T1TCI group and SD group at different time points (P0.05). The time of respiratory recovery, eye opening and extubation in TCI group was earlier than that in SD group (P0.05). However, the incidence of PONV in TCI group was significantly lower than that in SD group 24 hours after operation (P0.05). Conclusion: under BIS monitoring, target controlled total intravenous anesthesia with propofol and sevoflurane combined anesthesia can maintain hemodynamic stability and prevent intraoperative knowledge in patients undergoing laparoscopic hysterectomy. But the recovery rate of total intravenous anesthesia was faster than that of combined intravenous anesthesia, and the incidence of nausea and vomiting was lower 24 hours after operation.
【作者单位】：中南大学湘雅三医院麻醉科;
【基金】：国家自然科学基金项目(81400896;81471107)
【分类号】：R614.24

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