丙泊酚与依托咪酯对患者清醒后情绪变化影响的比较

The comparison of postoperative emotion alterations in surgical patients anesthetized with propofol or etomidate

目的比较丙泊酚和依托咪酯麻醉的手术患者清醒后情绪的变化。方法 120例自愿行无痛人工流产手术的患者,根据麻醉药物不同随机均分为丙泊酚组(P组)和依托咪酯组(E组)。分别在术前和麻醉清醒后对手术患者进行情绪评定。情绪评定采用正性负性情绪量表(PANAS),此表共20个形容词,其中描述正性情绪和负性情绪的各10项,每项有五个答案:1分,几乎没有;2分,比较少;3分,中等程度;4分,比较多;5分,极其多。记录两组术后恶心呕吐、头晕、腹痛及梦幻等不良反应的发生情况。结果麻醉后,P组SBP明显低于,HR明显慢于E组和麻醉前(P<0.05)。与术前比较,麻醉清醒后两组负性情绪评分均明显降低(P<0.05),P组正性情绪评分明显增高(P<0.05),E组正性情绪评分差异无统计学意义。术后头晕、恶心、腹痛的发生率两组差异无统计学意义;P组梦幻发生率为22例(36.7%),明显高于E组的8例(13.3%)。麻醉满意度两组均达到100%。结论丙泊酚比依托咪酯更易使手术患者在麻醉清醒后表现出积极、热情等正性情绪。

Objective To compare the postoperative emotion alterations in surgical patients anesthetized with propofol or etornidate.Methods One hundred and twenty patients undergoing artificial abortion were randomly divided into two groups receiving propofol （group P） or etomidate （group E） anesthesia respectively.Patient＇s emotion was evaluated by the positive and negative affect scale （PANAS） both before and after the procedure.PANAS is composed of 20 adjectives,among which,10 describe positive emotions and 10 decribe negative emotions.Each emotion has five levels：1,almost none; 2,little; 3,moderate; 4,extensive; and 5,severe.Adverse reactions such as dreams,dizziness,abdominal pain and vomiting after the procedure were recorded.Results After anesthesia,blood pressure and heart rate were lower in group P than those in group E （P＜0.05）.Scores of negative emotion in both groups were lower postoperatively compared to preoperatively （P ＜0.05）.The score of positive emotion in group P was higher after the procedure compared to that obtained preoperatively （P＜0.05）,while there was no significant changes of that in group E.There was no significant differences in the incidence of postoperative dizziness,nausea and abdominal pain between two groups.The incidence of dreams was 22（36.7％） in group P,and 8（13.3％） in group E.Patient＇s satisfactions were 100％ in both groups.Conclusion Patients anesthetized with propofol,compared to those anesthetized with etomidate,are more likely to show positive emotions such as activeness and enthusiasm after the procedure.Emotion alterations after propofol anesthesia have nothing to do with its quick action and low incidence of dizziness and nausea.