异丙酚靶控输注用于心内直视手术麻醉诱导时对血流动力学及心率变异性的影响

Effect of TCI of propfol on hemodynamics and HRV in the anesthesia induction of the intracardiac surgery

目的:观察异丙酚靶控输注(TCI)用于心内直视手术麻醉诱导时的血流动力学及心率变异性(HRV)变化。方法:28例心脏病患者随机分为A、B两组,A组采用Diprifu-sor/TCI系统分步诱导给药,B组人工推注异丙酚,观察HR、BP、SpO2、ECG、HRV诱导前(T0)、意识消失时(T1)、插管时(T2)、插管后1min(T3)、3min(T4)、5min(T5)变化。结果:A组各时点HR、SpO2、DBP与T0相比无明显变化(P>0.05),HRV、SDP各时点明显低于T0(P<0.05),但插管后无明显异常;B组T1、T2的HR、BP明显低于T0、T3、T4、T5,也明显低于A组各时点(P<0.05),T3的TP、HF明显低于T0和A组(P<0.05)。结论:异丙酚TCI分步诱导可以安全地用于心内直视手术的麻醉诱导。

Objective: To observe the hemodynamics and HRV caused by TCI during the induction period of the intracardiac surgery. Methods:28 cases of cardiopathy were chosen and divided into 2 groups as A and B which accepted propfool infusion by Diprifusor/TCI system or by manual respectively. The HR、Bp、SpO_2、ECG and HRV were observed 6 times on T_0(pre-induction), T_1(unconsciousness),T_2(intubating),T_3(1min after intubating),T_4(3mins after intubating) and T_5(5mins after intubating).Results: Hardly any change of the HR,Spo_2 and DBp occurred in the group A compared with those indexes of T_0 while the HRV and SBP decreased on T1 and T_2 as compared with T_0(P<0.05). All the indexes observed in group A on T_3,T_4 and T_5 became normal as T_0 without obvious difference. The HR and Bp of group B on T_1 and T_2 became obviously lower than those on T_0,T_3,T_4 and T_5,and lower than those indexes of group A(P<0.05). Conclusion:The target controlled infusion (TCI) of propfol can be used in anesthesia induction of the intracardiac surgery safely.