嗜酒者丙泊酚静脉全麻药量及效应的临床观察

Clinical observation of intravenous anesthesia with propofol in alcoholic-addicted patients

目的观察嗜酒对丙泊酚用药量和麻醉效果的影响。方法嗜酒者与非饮酒者各40例,静注芬太尼0.002 mg/kg后继以4 mg.kg-1.min-1的速度缓慢静注丙泊酚,直至睫毛反射消失。记录丙泊酚用量、意识恢复时睁眼、对答和自行离去时间、各监测指标及不良反应。结果两组丙泊酚用量[(1.88±0.36)mg/kg与(1.59±0.35)mg/kg]、自行离去时间[(24.43±5.55)min与(27.78±4.65)min]、RR[(9.13±1.27)次/分与(10.88±1.40)次/分]、SpO2[(96.93±2.08)%与(97.90±0.98)%],差异均有统计学意义(P<0.01)。嗜酒者的咳嗽反应、舌根后坠、检查时肢体运动的比例较高,但恶心、呕吐的发生率低。结论嗜酒者丙泊酚诱导剂量显著增加,恢复时间短,呼吸抑制增强,恶心呕吐发生率低。

Objective To study the anesthetic effect of propofol in alcoholic-addicted patients. Methods Eighty patients were divided into alcoholic-addicted group （T） and nonalcoholic-addicted group（C） with 40 cases each. Propofol was infused at a rate of 4 mg ·kg^-1· min^-1 until eyelid reflection disappeared after fentanyl 0. 002 mg/kg was given intravenously slowly. Propofol dosage, awake time,various monitoring indexes and side effects were recorded. Results The propofol dosage of group T was significant greater than that of group C[（1.88 ± 0.36） mg/kg vs. （1.59 ±0.35） mg/kg]（P〈0.01）. But the time of leaving for home in group T was remarkably earlier than the in group C[（24.43±5.55） min vs. （27.78±4.65） min]（P〈0.01）. The incidences of cough reaction, limbs moving, tongue falling backwards during anesthesia were more, hut nausea and vomiting was less in group T than those in group C. Conclusion Compared to the nonalcoholics,the alcoholic patients need more dose of propofol, have increased respiratory depression, but recovery is earlier with less nausea and vomiting.