异丙酚和七氟醚麻醉诱导插管时血糖、皮质醇的变化

Comparation of propofol and sevoflurane in effecting blood sugar and cortisol cluring intubation of induction

目的观察异丙酚和七氟醚麻醉诱导中血糖、皮质醇的变化,以评价两药对应激反应的抑制作用。方法本实验选择ASAⅠ-Ⅱ级择期行腹腔镜胆囊切除术(LC)病人40例,随机分为异丙酚组(Ⅰ组)和七氟醚组(Ⅱ组),每组20例,Ⅰ组异丙酚静脉诱导,Ⅱ组七氟醚吸入诱导。观测两组病人在诱导前、气管插管2 min、10 min时的SBP、DBP、HR、SpO2、血糖、皮质醇及插管时的体动、呛咳情况,所有数据进行统计学分析。结果插管2 min、插管10 min时,Ⅰ组、Ⅱ组SBP、DBP均比诱导前显著降低(P<0.01),两组间比较Ⅰ组DBP比Ⅱ组DBP均显著降低(P<0.01);血糖均比诱导前显著降低(P<0.05);插管2 min时,皮质醇均比诱导前显著降低,Ⅰ组(P<0.05),Ⅱ组(P<0.01)。插管10min时,两组皮质醇变化不明显,两组病人各时点的HR、SpO2变化不明显。结论在抑制插管时应激反应方面,七氟醚吸入麻醉优于异丙酚静脉麻醉。

Objective To investigate the effect of propfol and sevoflurane in stress reaction and hemodynanics and to provide a more ideal anethesia method. Methods Group I with 20 cases, induced with propfol and propfol injected at 4 - 8 μg/kg/h for anethesia maintainence;Group Ⅱ with 20 cases too, induced with sevoflurane and 1% - 2% sevoflurane inhaled for maintainence. Then observe the variation of blood sugar, cortisol, SBP, DBP, HR and SpO2 in different time in both groups. Results SBP, DBP, HR and SpO2 in Group I is lower than Group II （P 〈 0.05） during the operation, the corticol level in Group I is obviously higher than in Group Ⅱ （ P 〈 0.01） during and post operation and the blood sugar level in Group I is much higher than Group Ⅱ （P 〈 0.01） post operation. Conclusion Inhalation of sevoflurane can leads to less stress and minor variation in hemodynamics than injection of propfol does,so it is better for anethesia.