丙泊酚预防硬膜外阻滞上腹部手术牵拉反应的疗效观察

Clinical Observation of Propofol in Preventing Visceral Traction Reaction During Upper Abdominal Operations Under Epidural Blockade

目的研究异丙酚静脉输注预防硬膜外阻滞下行上腹部手术内脏牵拉反应效果。方法选择硬膜外麻醉下上腹部手术患者70例,随机分为A组(异丙酚组)和B组(芬氟组),每组35例。A组患者在切皮前静注异丙酚1.5 mg/kg,再以4 mg(kg.h)静脉维持;B组在切皮前静注芬太尼1μg/kg,氟哌啶0.05 mg/kg。记录患者术中HR、MAP、SpO2及牵拉反应情况。结果A组内脏牵拉反应及嗜睡发生率明显低于B组(P<0.01)。两组患者用药前后HR和MAP无显著差异。B组SpO2在注药后5 min较麻醉前明显下降(P<0.05)。结论异丙酚能明显预防上腹部手术中内脏牵拉反应。

Objective To investigate the effects in preventing visceral traction reaction with propofol during upper abdominal operations under epidural blockade.Methods 70 upper abdominal surgical patients under epidural blockade were allocated randomly into two greups,propofol group（group A, n = 35） and fontanyl with droperidol greup（greup B, n = 35）.In group A propofol 1.5 mg/kg was injected and infused at a rate of 4 mg,/（kg· h）, In group B fentanyl 1 μg/kg and dropefidol 0.05 mg/kg were administered before skin incision. HR, MAP, SpO2 and visceral traction reaction were recorded during opertion. Results The aocidenocs of visceral traction reaction and somnolency in group A were significantly less than those in group B （ P 〈 0.01）. No statistical differences were found in HR and MAP between two groups. SpO2 decreased significantly at 5 min after fentanyl and dropefidol were administered in group B. Conclusion Visceral traction reaction can be effectively prevented during upper abdominal operations under epidural blockade with propofol.