摘要
目的比较静脉靶控输注(TCI)与泵注丙泊酚用于乳腺微创旋切手术麻醉的效果及不良反应。方法选择择期行乳腺微创旋切术的患者70例,ASAⅠ~Ⅱ级,随机分为静脉泵注(C组)和TCI丙泊酚(T组)两组,每组各35例。两组患者输入5 ml/kg醋酸钠林格液后,予1μg/kg芬太尼静脉注射,C组给予2 mg/kg丙泊酚静脉注射,随后以2. 5 mg·kg^^-1·h^^-1速度恒速泵注;T组丙泊酚TCI,初始血浆靶浓度设定为2. 0μg/m L;手术开始前两组患者均使用1%利多卡因行局部浸润麻醉,根据术中体动反应调节麻醉深度,C组单次快速静脉注射丙泊酚0. 5 mg·kg^-1·h^-1;T组丙泊酚血浆靶浓度在原来基础上增加0. 2μg/m L两组均在手术结束前5 min停止丙泊酚的输注。监测心电图、脉搏氧饱和度(Sp O2)、血压和呼吸频率。记录注射痛、呼吸抑制、循环抑制和术中体动发生例数。结果两组术前MAP、HR、Sp O2和术中HR、Sp O2组间比较差异无统计学意义(P> 0. 05);C组术中MAP明显低于T组(P <0. 05)。两组手术时间、苏醒时间及丙泊酚用量差异无统计学意义(P> 0. 05);C组诱导时间明显短于T组(P <0. 05)。C组丙泊酚注射痛、循环抑制和术中体动的发生率明显高于T组(P <0. 05);两组呼吸抑制的发生率差异无统计学意义(P> 0. 05)。T组的Ramsay镇静评分优于C组(P <0. 05)。T组患者出院时质量评分优于C组(P <0. 05)。T组患者满意度评分优于C组(P <0. 05)。结论与丙泊酚静脉泵注比较,丙泊酚TCI具有循环稳定,患者体动少,镇静效果好等优点,日间手术患者住院时间较短,一定程度降低患者住院费用,患者满意度高。
Objective To compare the efficacy and adverse reactions of intravenous target-controlled infusion( TCI) and pump propofol for minimally invasive mammotomy. Methods Seventy patients undergoing selective minimally invasive circumcision of the breast,were randomly divided into intravenous pump group( group C) and TCI group( group T),with 35 cases in each group. After 5 ml/kg sodium acetate Ringer’s solution was administered to the two groups,1 μg/kg fentanyl was injected intravenously. Group C was given 2 mg/kg propofol intravenously and then pumped at a constant speed of2. 5 mg·kg^-1·h^-1;The initial target plasma concentration of propofol TCI in group T was set at 2. 0 μg/m L. Local infiltration anesthesia with 1% lidocaine was performed in both groups before operation,adjusting the depth of anesthesia according to the intraoperative body motion response,group C received a single rapid intravenous injection of propofol 0. 5 mg·kg(^-1)·h(^-1);The plasma target concentration of propofol in group T increased by 0. 2 μg/m L on the original basis. The infusion of propofol was stopped 5 minutes before the end of operation in both groups. Electrocardiogram,pulse oximetry( Sp O2),blood pressure and respiratory rate were monitored,and the number of injection pain,respiratory depression,circulatory inhibition,and intraoperative body motion were recorded. Results There were no significant differences in MAP,HR,Sp O2 and intraoperative HR and Sp O2 between the two groups( P > 0. 05). The intraoperative MAP was significantly lower in the C group than in the T group( P < 0. 05). There was no significant difference in the operation time,recovery time and propofol dosage between the two groups( P > 0. 05). The induction time in group C was significantly shorter than that in group T( P <0. 05). The incidence of propofol injection pain,circulatory inhibition and intraoperative body motion in group C was significantly higher than that in group T( P < 0. 05). There was no significant difference in the incidence of respiratory depression between the two groups( P > 0. 05). The Ramsay sedation score of the T group was better than that of the C group( P <0. 05). The quality score of patients in group T was better than that in group C( P < 0. 05). The satisfaction score of patients in group T was better than that in group C( P < 0. 05). Conclusion Compared with propofol intravenous pumping,propofol TCI has the advantages of stable circulation,less body movement and better sedative effect. The hospitalization time of patients with day surgery is shorter,which reduces the hospitalization cost of patients to a certain extent,and the patient satisfaction is high.
作者
黄晓光
HUANG Xiaoguang(Chaozhou Central Hospital, Chaozhou 521000, China)
出处
《现代医院》
2019年第9期1360-1362,共3页
Modern Hospitals
关键词
丙泊酚靶控输注
乳腺微创旋切术
日间手术
Propofol Target-Controlled Infusion
Minimally Invasive Mammography
Day Surgery
