蛛网膜下腔阻滞和静脉全麻时丙泊酚镇静剂量的比较

Effects of subarachnoid block on sedative requirement for propofol

目的比较布比卡因蛛网膜下腔阻滞和静脉全麻时丙泊酚镇静剂量差异,并探讨其可能的机制。方法行下腹部妇科手术患者54例,ASAⅠ或Ⅱ级,随机均分为蛛网膜下腔阻滞组(S组)和静脉全麻组(G组)。S组在阻滞完成后15 min泵注丙泊酚,G组入室后10 min泵注丙泊酚实施全麻。比较两组患者意识消失时丙泊酚的用量。结果意识消失时S组所需丙泊酚用量为(1.12±0.18)mg/kg,明显少于G组的(1.73±0.19)mg/kg(P<0.01)。结论与静脉全麻相比,蛛网膜下腔阻滞时能减少丙泊酚镇静剂量。

Objective To investigate the effects of subarachnoid block on the sedative requirement for propofol. Methods Fifty-four gynecologic patients （ASA Ⅰ or Ⅱ ） undergoing lower abdominal operation were randomly divided into two groups. In subarachnoid block group （group S）, patients received subarachnoid bupivacaine block, followed by intravenous infusion of propofol started at 15 minutes after intrathecal injection; in general anesthesia group （group G）, patients only received intravenous infusion of propofol without subarachnoid block. The requirements for propofol and BIS values when patients lost consciousness （i. e. sedated） were recorded in two groups. Results The sedative requirement for propofol in group S was significantly less than that in group G [（1.12± 0.18） mg/kg vs. （1.73±0. 19） mg/kg, P〈0.01]. There were no significant differences in BIS values at all corresponding time points between two groups. Conclusion Subaraehnoid block can reduce the sedative requirement for propofol.