丙泊酚靶控输注在逆行胆胰管造影术中的应用

The Application of Propofol in ERCP by Target Controlled Infusion

目的观察在逆行胆胰管造影术（ERCP）检查中采用丙泊酚靶控输注的麻醉效果,并与人工输注丙泊酚麻醉进行比较。方法选择ASAⅠ-Ⅱ级60例拟行ERCP检查的住院病人,随机分为人工输注丙泊酚组（M组）与靶控输注丙泊酚组（T组）,每组30例。记录麻醉前、睫毛反射消失时、内窥镜置入时、Oddis括约肌切开时、造影时、术毕和苏醒时的SBP、DBP、HR、SpO2的变化,记录意识消失时间、苏醒时间及丙泊酚总量。结果T组与M组患者在注药后SBP、DBP、HR、SpO2成V字型变化,睫毛反射消失时较注药前SBP、DBP、HR、SpO2均有不同程度的下降（P〈0.05）,其后则基本维持稳定,2组间比较无显著差异（P〉0.05）。T组意识消失、恢复时间明显短于M组（P〈0.01）,而丙泊酚的总量显著少于M组。结论靶控输注与人工输注相比,因其个性化的给药方式不仅使患者的循环、呼吸更加更加平稳,而且诱导迅速、苏醒完全,因此使麻醉更加精确、简便,提高了麻醉的整体质量。

Objective To observe the anaesthetic effect of propofol used in ERCP by target controlled infusion（TCI）, compare the anaesthetic effect of propofol used in ERCP by artificial infusion. Methods Sixty cases arranged ERCP were selected and they were all in grade ASA Ⅰ - Ⅱ and divided into group artificial infusion （group M）and group TCI （group T ） randomly with 30 cases in each group. The SBP,DBP,HR and the change of SpO2 were record before the anesthesia. When the lash reflex was disappeared, the endoscope was inserted and the Oddis sphincter muscle was cut open. The visualization was in progress, the operation was finished and an- alepsia. The consciousness exitinction time, record. Results After administration, there analepsia time and the total dosage of propofol were was a Ⅴ shape change of SBP, DBP, HR and SpO2 in two groups. The SBP, DBP, HR and the SpOz were decreased when the lash reflex was disappeared （P〈0.05）, and then keep stable. There was no difference between the two groups （P〉 0.05）. In group T, the consciousness exitinction time and the coincidence time were shorter than group M obviously （P〈0.01）. However, the total dosage of propofol in group T was less than group M. Conclusion The personality method of administration of TCI infusion could stable the circulation and respiration of patients, induce the anesthesia quickly and analepsia completely. Therefore this method can make the anesthesia much more precise, more convenient and can increase the whole quality of anesthesia.