丙泊酚靶控输注与恒速输注复合瑞芬太尼全凭静脉麻醉下腹腔镜手术的比较

A COMPARISON OF TARGET CONTROLLED INFUSION OF PROPOFOL WITH CONSTANT INFUSION IN PATIENTS UNDERGOING LAPAROSCOPIC OPERATIONS

目的比较丙泊酚靶控输注(Target Controlled Infusion,TCI)与恒速输注复合瑞芬太尼(Remifentanil,REM)全凭静脉麻醉下腹腔镜手术的效果。方法选择200例择期腹腔镜手术患者,随机分为丙泊酚TCI组(T)组和恒速输注组(H)组:T组负荷、维持量丙泊酚血药浓度均为(Cp)3μg/ml;H组丙泊酚负荷量1·8mg/kg,维持量7mg·kg-1·h-1,两组均复合REM负荷量1μg/kg,维持量0·25μg-1·kg-1·min-1。记录两组患者围麻醉期血流动力学变化、丙泊酚用量及术毕停药后不良反应。结果丙泊酚T组围麻醉期血流动力学变化相对较小。结论丙泊酚TCI组复合REM全凭静脉麻醉诱导更平稳,术中血流动力学稳定,麻醉深度可控制性较好。

Objective To investigate the effect of target controlled infusion （TCI） of propefol in patients undergoing laparoscopic operations. Methods Two hundred patients undergoing laparoscopic operations were randomly divided into group T and group H. The patients in group T were induced and maintained with TCI of propofol,the predictable plasma drug concentration was 3 tag/ml. Group H was taken as control group, anesthesia was induced with propofol 1.8 mg/kg,then maintained with constant infusion of propofol at the speed of 7 mg·kg^-1·h^-1. The patients in both groups were induced with remifentanil 1 μg/kg and maintained at 0.25μg^-1·kg^-1·min^-1 during the anesthesia. The changes of hemodynamics parameter and the total amount of propofol were recorded. The postoperative side efleets were observed. Results There were significant difference between the two groups ; the changes of hemodynamits parameter in group T were smaller than in group H. Conclusion TCI of propofol has good controllability. The patients undergoing TCI of propofol have stable hemodynamics.