不同剂量丙泊酚复合依托咪酯全麻诱导效果比较

Efficacy of propofol at different doses combined with etomidate for general anesthesia induction

目的观察不同剂量丙泊酚复合依托咪酯应用于全麻诱导的血流动力学、脑电双频指数(BIS)变化特点及不良反应。方法选择择期全麻手术患者90例,随机分为三组,每组30例。诱导方案:A组静注丙泊酚1.5 mg/kg、依托咪酯0.075 mg/kg;B组静注丙泊酚1 mg/kg、依托咪酯0.15 mg/kg;C组静注丙泊酚0.5 mg/kg、依托咪酯0.225 mg/kg。诱导完成后行气管插管。观察记录诱导前(T_(0))、插管前(T_(1))、插管后1、3、5 min(T_(2)~T_(4))三组患者MAP、HR、BIS的变化,记录三组患者注射痛、肌阵挛等不良反应发生率。结果A组诱导后的MAP、HR低于B、C组,BIS高于B、C组(P<0.05);A组注射痛发生率低于B组(P<0.05);A、B组肌阵挛发生率低于C组(P<0.05)。结论丙泊酚1.5 mg/kg复合依托咪酯0.075 mg/kg用于全麻插管对血流力学和BIS影响小、不良反应少。

Objective To explore the changes of hemodynamics and bispectral index(BIS)when propofol is combined with etomidate for induction of general anesthesia.Methods Ninety patients scheduled for general anesthesia in our hospital between October 2018 and March 2019 were enrolled.These patients were randomly divided into three groups,with 30 patients in each group.Anesthesia induction methods included propofol 1.5 mg/kg+etomidate 0.075 mg/kg in group A,propofol 1 mg/kg+etomidate 0.15 mg/kg in group B,and propofol 0.5 mg/kg+etomidate 0.225 mg/kg in group C.MAP,HR,BIS were measured before induction(T_(0)),before intubation(T_(1)),and 1,3 and 5 minutes after intubation(T_(2~4)).Such adverse reactions as injection pain and myoclonus in each group were recorded.Results MAP and HR in group A were lower than in the other two groups,but BIS in group A was higher(P<0.05).MAP in group C increased significantly at T_(2)(P<0.05),and BIS in group A was higher than in group C at T_(1-2)(P<0.05).The incidence of injection pain was lower in group A and group B(P<0.05).The incidence of myoclonus was lower in group A and group B than in group C(P<0.05).Conclusions Propofol 1.5 mg/kg combined with etomidate 0.075 mg/kg is a better agent for general anesthesia induction as evidenced by hemodynamic and BIS stability and fewer adverse reactions.