汉族和哈萨克族靶控输注丙泊酚浓度差异的观察

Observation of the difference of target effect-site concentration about propofol between Han and Kazak nationality

目的探讨新疆汉族、哈萨克族间民族差异对患者全麻诱导时不同镇静深度下靶控输注(TCI)丙泊酚效应室浓度(Ce)的影响。方法拟行全麻的骨科患者42例,按民族分为两组:汉族组(H组)和哈萨克族组(K组),每组21例。麻醉诱导:两组患者均静注芬太尼后,TCI丙泊酚至脑电双频谱指数(BIS)降到40～50后静注维库溴铵,气管插管,机械通气。观察麻醉诱导前(T0)、静注芬太尼4min后(T1)、意识消失时(T2)、BIS降到40～50时(T3)、静注维库溴铵4min后(T4)、气管插管即刻(T5)、插管后1min(T6)、3min(T7)、5min(T8)时SBP、HR、BIS值和T2、T3时的丙泊酚Ce值及用药剂量。同时记录意识消失时间、达插管深度时间。结果 T2、T3时K组丙泊酚Ce高于H组(P<0.05);K组意识消失时间、达插管深度时间长于H组,丙泊酚用药量大于H组(P<0.01)。结论哈萨克族患者复合等量芬太尼麻醉诱导时不同镇静深度下所需TCI丙泊酚浓度较汉族患者大,临床麻醉中应区别用药。

Objective To investigate the effects of different ethnic on the target effect-site concentration of TCI propofol（Ce） at different sedation levels between Han and Kazak nationality during anesthesia induction. Methods 42 patients scheduled for orthepedics surgery with general anesthesia were randomly divided into 2 groups： group H （Han nationality, 21 patients）, group K （Kazak nationality, 21 patients）. Anesthesia was induced with injection of fentanyl and TCI of propofol until the BIS declined to 40-50, tracheal intubation was facilitated with vecuroniurn. The patients were mechanically ventilated. SBP, HR, BIS were recorded before induction of anesthesia （T0）,at 4 min after injection of fentanyl（T1 ）, lost of consciouse（T2 ）, the BIS decreased to 40-50 （T3） ,at 4 min after injection vecuronium（T4 ）, immediately（T5 ）and at 1 min（T6 ）, 3 min（T7 ） ,5 min （T8） after tracheal intubation. The Ce and consumption of propofol at T2 ,T3 was recorded, the time from T1 to T2 （lost of consciouse）, T1 to T3 （to reach the deep of anesthesia adapt to tracheal intubation） was also recorded. Results The Ce and consumption of propofol at T2 and T3 was higher in group K than in group H （P 〈0.05）. The time of lost of consciouse and the time to reach the deep of anesthesia adapt to tracheal intubation in group K was significantly longer than in group H （P 〈 0. 01）. Conclusion The target effect-site concentration of TCI propofol in Kazak groups was higher than that in Han nationality at different sedation levels during anesthesia induction when combined with same dose of fentanly, we should not give the same dose in the two nationality during clinical anesthsia.