增加丙泊酚在LC术麻醉诱导用量的临床分析(1)
[摘要] 目的 增加丙泊酚在LC术麻醉诱导用量对患者的影响。方法 方便选取2017年2月—2018年2月于该院择期接受LC术的患者60例，随机分为2组(n=30)：诱导增加丙泊酚用量组(A组)和丙泊酚合并咪达唑仑组(B组)，比较两组患者在诱导插管时(T1)、插管后5min(T2)、气腹开始时(T3)、手术5min(T4)、手术结束时(T5)、拔管时(T6)的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)及拔管后患者恶心呕吐、术后躁动发生情况。结果 A组患者在T1时的SBP、DBP、MAP、HR分别为(101.2±7.6)mmHg、(59.5±6.4)mmHg、(77.4±6.3)mmHg、(66.3±6.4)次/min，与B组相比明显要低，T2、T3、T4、T5、T6时的SBP、DBP、MAP、HR也明显较B组低，差异有统计学意义(P<0.05)。A组手术麻醉结束至清醒时间>10 min的患者仅有1例，明显少于B组的11例(χ2=10.417，P<0.05)，术后未出现恶心呕吐者28例，明显多于B组的21例(χ2=5.455，P<0.05)，且躁动者仅有1例，明显少于B组的5例(χ2=3.363，P<0.05)。结论 增加丙泊酚在LC术中麻醉诱导的用量有利于维持术中血流動力学平稳，可有效减少术后恶心呕吐、躁动的发生。
[关键词] 丙泊酚；麻醉诱导；腹腔镜胆囊切除术；恶心呕吐；术后躁动
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2018)06(a)-0120-03
[Abstract] Objective This paper tries to explore the effect of increasing the dosage of propofol on the patients with laparoscopic cholecystectomy. Methods 60 patients undergoing elective LC surgery in this hospital from February 2017 to February 2018 were convenient selected and randomly divided into 2 groups (n=30)： Propofol-increase group (group A) and propofol combined In the midazolam group (group B)， two groups of patients were compared when they were intubated (T1)， 5 minutes after intubation (T2)， at the beginning of pneumoperitoneum (T3)， 5 min after surgery (T4)， and at the end of the surgery (T5). At the time of extubation (T6)， systolic blood pressure (SBP)， diastolic blood pressure (DBP)， mean arterial pressure (MAP)， heart rate (HR)， nausea and vomiting after extubation， and postoperative agitation occurrence. Results In group A， SBP， DBP， MAP， and HR at T1 were (101.2±7.6) mmHg， (59.5±6.4) mmHg， (77.4±6.3) mmHg， (66.3±6.4) times/min， respectively， compared with group B. Compared with B， the SBP， DBP， MAP， and HR at T2， T3， T4， T5， and T6 were significantly lower than those in Group B， and the difference was statistically significant(P<0.05). In group A， there was only one patient who had an anesthesia to an awake time >10 min， which was significantly less than that of group B(χ2=10.417， P<0.05). There were 28 patients who did not have nausea or vomiting after operation， which was significantly more than that of group B. 21 patients (χ2=5.455， P<0.05) and only one indwelling person were significantly less than those in group B(15 cases)(χ2=3.363， P<0.05). Conclusion Increasing the amount of propofol induced by intranasal anesthesia in LC surgery is conducive to the maintenance of intraoperative hemodynamic stability， which can effectively reduce the incidence of postoperative nausea， vomiting and restlessness., 百拇医药(李红喜)
[关键词] 丙泊酚；麻醉诱导；腹腔镜胆囊切除术；恶心呕吐；术后躁动
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2018)06(a)-0120-03
[Abstract] Objective This paper tries to explore the effect of increasing the dosage of propofol on the patients with laparoscopic cholecystectomy. Methods 60 patients undergoing elective LC surgery in this hospital from February 2017 to February 2018 were convenient selected and randomly divided into 2 groups (n=30)： Propofol-increase group (group A) and propofol combined In the midazolam group (group B)， two groups of patients were compared when they were intubated (T1)， 5 minutes after intubation (T2)， at the beginning of pneumoperitoneum (T3)， 5 min after surgery (T4)， and at the end of the surgery (T5). At the time of extubation (T6)， systolic blood pressure (SBP)， diastolic blood pressure (DBP)， mean arterial pressure (MAP)， heart rate (HR)， nausea and vomiting after extubation， and postoperative agitation occurrence. Results In group A， SBP， DBP， MAP， and HR at T1 were (101.2±7.6) mmHg， (59.5±6.4) mmHg， (77.4±6.3) mmHg， (66.3±6.4) times/min， respectively， compared with group B. Compared with B， the SBP， DBP， MAP， and HR at T2， T3， T4， T5， and T6 were significantly lower than those in Group B， and the difference was statistically significant(P<0.05). In group A， there was only one patient who had an anesthesia to an awake time >10 min， which was significantly less than that of group B(χ2=10.417， P<0.05). There were 28 patients who did not have nausea or vomiting after operation， which was significantly more than that of group B. 21 patients (χ2=5.455， P<0.05) and only one indwelling person were significantly less than those in group B(15 cases)(χ2=3.363， P<0.05). Conclusion Increasing the amount of propofol induced by intranasal anesthesia in LC surgery is conducive to the maintenance of intraoperative hemodynamic stability， which can effectively reduce the incidence of postoperative nausea， vomiting and restlessness., 百拇医药(李红喜)