异丙酚预防腹腔镜胆囊切除术后病人恶心呕吐发生的最佳剂量研究

Optimum dose of propofol for prevention of emetic episodes after laparoscopic cholecystectomy

目的:探讨异丙酚预防腹腔镜胆囊切除术后病人术后恶心呕吐(PONV)发生的最佳剂量。方法:选择ASAⅠ～Ⅱ级在全麻下行腹腔镜胆囊切除术病人80例,随机分为四组:C组(输入0.9%氯化钠注射液,n=40)、P0.5组(异丙酚0.5mg·Kg-1·h-1,n=40)、P1.0组(异丙酚1.0mg·Kg-1·h-1,n=40)和P1.5组(异丙酚1.5mg·Kg-1·h-1,n=40)。所有药物在病人麻醉诱导后开始输注。记录术后24小时病人PONV发生率。结果:C组、P0.5组、P1.0组和P1.5组四组患者术后24h内PONV总发生率分别为65%、60%、20%和15%,在24h观察期内,P1.0组和P1.5组患者PONV预防明显好于C组、P0.5组(P<0.05),而P1.0组和P1.5组间术后24h内PONV总发生率差异无统计学意义。结论:异丙酚1.0和1.5mg·K-1·h-1输注都能明显减少腹腔镜胆囊切除术后恶心的发生率,但增加剂量至1.5mg·Kg-1·h-1并不会增加镇吐效能,因此异丙酚1.5mg·Kg-1·h-1输注是预防腹腔镜胆囊切除术后病人恶心呕吐发生的最佳剂量。

Objective： To estimate the optimum dose of propofol for reducing emetic episodes after laparoscopic cholecystectomy. Methods：80 patients were divided into 4 groups received either placebo or three different deses（0.5mg·Kg^-1·h^-1, 1.0mg·Kg^-1·h^-1,1.5mg·Kg^-1, h^-1 ）of propofol immediately after induction of anesthesia. Emetic episodes were recorded and safety assessments were performed during 0-24 hours after the surgry. Results： The incidence of patients with emetic episodes during 0-24 hours after surgry was 60% with 0.5mg·Kg^-1·h^-1（ P 〉 0.05） ,20% with 1.0mg·Kg^-1·h^-1（ P 〈 0.01） and 15% with 1.5mg·Kg^-1·h^-1（ P 〈 0.01）of pmpofol compared with placebo（65% ）. Conduslorla： We conclude that propofol 1.0mg·Kg^-1·h^-1 is the optimum dose for reducing emetie symptoms after laparoscopie eholecystectomy. Increasing the dose to 1.5mg·Kg^-1·h^-1 provides no further benefit.