静脉异丙酚辅助硬膜外麻醉的研究

PROPOFOL AS AN ADJUVANT FOR EPIDURAL ANESTHESIA

目的：为探讨异丙酚辅助硬膜外麻醉对循环、呼吸的影响及评价术中镇静的效果。方法；随机选择90例盆腔手术的病人，分成3组，每组30例，静注哌替啶、异丙嗪合剂作为对照为Ⅰ组；静注异丙酚1mg／kg负荷剂量后，以50μg／kg·min(-1)速度连续静脉输注作为Ⅱ组，以70μg／kg·min(－1)速度连续静脉输注作为巩组。结果：3组用药后的潮气量（TV）均较基础值减少；呼吸频率（RR）在前15min均减慢，以Ⅰ、Ⅲ组明显。Ⅱ、Ⅲ组用药后的平均动脉压（MAP）均较基础值降低，且Ⅲ组较Ⅱ组明显。术中镇静效果以Ⅱ组最佳。结论：认为静注1mg／ks负荷剂量后持续以50μg／kg·min(-1)连续静注异丙酚辅助硬膜外麻醉效果好。

Objective: To study the degree and process of cardiopulmonary effect and sedation effect of propofol as an adjuvant for epidural anesthesia. Method: 90 patients receiving epidural anesthesia were divided at random into three groups. Group Ⅰ received dolantin 1 mg/kg and phenergan 0. 5 mg/kg for intravinous injection. Group Ⅱ received propofol 1 mg/kg in bolus, followed by 50 μg/kg· min-1 infusion for maintenance. Group Ⅲ received propofol 1 mg/kg in bolus, followed by 70 μg/kg·min-1 infusion for maintenance. MAP. HR. SpO2. TV and RR were monitored during the courses. Result: TV significantly decreased in all groups during the operation; the RR were slow significantly in 15 mintues after using the adjuvant in all groups and were slower in Group Ⅰ and Group Ⅲ. The level of MAP significantly decreased in both Group Ⅱ and Group Ⅲ, but more significantly in Group Ⅲ. Group Ⅱ had the best sedation effect of the three groups. Conclution: Infusion propofol 50 μg/kg·min-1 for maintenance after 1 mg/kg in bolus as an adjuvant for epidural anesthesia is applicable.