小剂量丙泊酚在全麻拔管期中的应用

Application of low-dose propofol during anesthesia extubation period

目的:观察小剂量丙泊酚在全麻拔管期对患者的影响。方法:将40例ASAⅠ～Ⅱ级全麻手术后患者,随机分为两组:丙泊酚组(Ⅰ组)于手术结束达到拔管条件,静脉注射丙泊酚1mg·kg-1,2min后吸痰拔管;对照组(Ⅱ组)达到拔管条件,不予镇静,吸痰后拔除气管导管。观察各组拔管前5min、拔管即刻、拔管后5min时的心率(HR)、平均动脉压(MAP)、呛咳反应、拔管后清醒时间、拔管知晓率。结果:Ⅰ组拔管期MAP、HR值较稳定,与拔管前比较差异无统计学意义(P>0.05);Ⅱ组拔管即刻、拔管后5min时MAP、HR较拔管前均明显增加(P<0.01或P<0.05)。Ⅰ组患者术后清醒时间明显长于Ⅱ组(P<0.05),Ⅱ组重度呛咳反应发生率、拔管知晓率较Ⅰ组明显增高(P<0.01或P<0.05)。结论:小剂量丙泊酚可用于抑制全麻拔管期反应。

Objective：To investigate the effects of low-dose propofol during anesthesia extubation period.Methods：Forty general anesthesia cases categorized as ASA Ⅰ-Ⅱ grade were randomly divided into propofol group（groupⅠ）and control group（groupⅡ）.Patients in groupⅠ,were administrated with 1 mg/kg propofol when the operation was over and anesthesia tube was about to be removed in 2 min after sputum suction.While for groupⅡ,anesthesia tube was directly removed after sputum suction.Heart rate,mean arterial blood pressure at three time points including 5 min before and after the extubation,the extubation moment,were recorded and compared.Cough response at extubation,time of consciousness regain after extubation,and rate of extubation awareness were also observed.Results：For group Ⅰ,heart rate,mean arterial blood pressure after extubation were stable compared with that before the extubation,while for group Ⅱ,the same parameters increased significantly after extubation（P〈0.01 or P〈0.05）.Group Ⅰ showed longer time of consciousness regain（P〈0.05）,while lower rate of severe cough response and extubation awareness（P〈0.01 or P〈0.05）.Conclusion：Low-dose propofol is effective on suppressing responses during anesthesia extubation period.