异丙酚静脉麻醉对患者心率变异和血糖水平变化的影响

Effect of propofol intravenous anesthesia on heart rate variability and blood sugar level

目的研究异丙酚静脉麻醉对糖尿病患者心率变异和血糖水平变化的影响。方法将56例全麻患者分为两组,治疗组29例为糖尿病患者,对照组患者27例均未患糖尿病。两组患者均静脉滴注异丙酚0.7 mg/kg,然后根据情况追加首次量的1/4～1/2,监测两组患者平均动脉压(MAP)、动脉血氧饱和度(SpO2)、心率(HR)及警觉/镇静评分达3分即刻、5 min、10 min时HRV各参数;监测麻醉诱导前、诱导后插管前、插管后5 min、插管后30 min、拔管后10 min的血糖水平。结果与对照组相比,插管后实验组患者LF、HF和TP均低于对照组(P<0.05),两组患者LF/HF均较基础值升高,而实验组LF/HF较对照组升高显著(P<0.05)。结论异丙酚有加重糖尿病患者术中自主神经的紊乱性和升高血糖的不良反应,对于糖尿病患者的手术麻醉应慎用异丙酚。

Objective To study the effects of propofol intravenous anesthesia on heart rate variability and blood sugar level of diabetes. Methods Fifty-six cases of general anesthesia patients were randomly divided into two groups,treatment group,twenty-nire cases of diabetic patients,the control group,twenty-seven cases of patients without diabetes.Two groups of patients were intravenous propofol 0.7 mg/kg,then give an additional quantity of 1/4-1/2 of the first time according to The actual situation.Monitoring the two groups of patients with mean arterial pressure（MAP）,peripheral oxygen saturation（SpO2）,heart rate（HR） and the parameters of HRV when OAA/S rating of 3 hours,5 min,10 min;monitoring before anesthesia induction,after induction play tube before intubation,after 5 min,after intubation 30 min,extubation after 10 min of blood glucose.Results Compared with control group,the experimental group after intubation in patients with LF,HF and TP were lower than the control group（P0.05）,two groups of patients with LF/HF were higher basic values,while LF/HF in the experimental group increased significantly than in the control group（P0.05）.Conclusion Propofol has aggravated diabetic patients with autonomic nervous disorders and elevated blood glucose side effects,for diabetic patients at propofol anesthesia used with caution.