丙泊酚静脉麻醉应用于直肠癌根治术的临床观察

Clinical Observation of Propofol Intravenous Anesthesia in the Treatment of Rectal Cancer

目的:观察丙泊酚静脉麻醉应用于直肠癌根治术的可行性和安全性。方法:将204例行直肠癌根治手术的老年患者随机分为丙泊酚组129例和布比卡因组75例,记录2组麻醉前(T0)、诱导后(T1)、切皮后30min(T2)、切皮后60min(T3)、术毕(T4),心脏功能、血液黏度、不良反应和手术后VAS评分。结果:2组诱导后心率(HR)、收缩压(SBP)及舒张压(DBP)均较麻醉前显著降低(P<0.05);手术开始时均较诱导后有所升高(P<0.05),丙泊酚组手术开始时的HR、SBP及DBP均显著低于布比卡因组(P<0.05);手术结束时,2组与麻醉前的HR、SBP及DBP比较差异均无统计学意义(P>0.05)。丙泊酚组不良反应发生率显著低于布比卡因组(P<0.05);2组VAS评分7分以上比较,差异均无统计学意义(P>0.05),但平均分数组间比较差异有显著性(P<0.05)。布比卡因组患者血液黏度在T1、T2、T3、T4时间点略有升高,且2组间血液黏度在T1、T2、T3、T4时间点比较差异均有统计学意义(P<0.05)。结论:丙泊酚静脉麻醉应用于直肠癌根治术血液流变学稳定,并发症少,且安全性较好。

To observe the feasibility and safety of propofol intravenous anesthesia for rectal cancer. METHODS： 204 patients undergoing routine rectal cancer surgery were randomly divided into propofol group （129 cases） and bupivacaine group （75 cases）. Cardiac function, blood viscosity, adverse drug reactions and post-operative VAS score in 2 groups were all recorded before anesthesia （T0）, after induction （T,）, 30 min after incision （T2）, 60 min after incision （T3）, at the end of surgery （T2）. RE- SULTS： HR, SBP and DBP in 2 groups after induction of anesthesia were significantly lower than before （P〈0.05）; All of them increased at the beginning of surgery, compared with after induction （P〈0.05）. HR, SBP and DBP at the beginning of propofol surgery were significantly lower than the bupivacaine group （P〈0.05）; at the end of surgery, there were no statistical significance in the differences of HR, SBP and DBP in 2 groups, compared with before anesthesia （P〉0.05）. The incidence of adverse drug re- actions in propofol group was significantly lower than in bupivacaine group （P〈0.05） ; VAS score of more than 7 segments, the difference between 2 groups were not statistically significant （P〉0.05）, and there was a significant difference in average scores be- tween 2 groups （P〈0.05）. The plasma viscosity of bupivacaine group increased slightly at T~, T2, T：~, T~, there were statistically significance （P〈0.05）. CONCLUSION： There are hemodynamic stability, fewer complications and good security due to propofol anesthesia for rectal cancer.