丙泊酚复合麻醉用于模拟复合战伤效果评价

Application of Propofol Combined Anesthesia in Complex Battle Injury

目的探索适宜复合战伤救治中使用的麻醉方法,提高战场伤员生存率。方法 2011年7～8月份用10条犬制作动物模型,用自制造模枪造成腹部复合伤。丙泊酚复合麻醉,诱导浓度为3 mg/kg,微量泵入丙泊酚12mL/h,维持麻醉;于介入方舱内实施微创介入手术;术中监测记录造模前(T0)、造模后5 min(T1)、麻醉诱导前(T2)、插管即刻(T3)、股动脉穿刺即刻(T4)、封堵栓塞前(T5)及术后15 min(T6)7个时间结点的鼻咽温度(NPT)、平均动脉压(MAP)及心率(HR)。观察动物的肢体活动、肌肉紧张及动物死亡情况。结果造模及术中各时间节点NPT均低于T0、T1(P<0.05);T0时点MAP明显高于T1～T5各时点的MAP(P<0.05);T1～T5的MAP明显低于T6(P<0.05);T1～T5之间MAP差异无统计学意义(P>0.05);T3～T5与T0的HR差异有统计学意义(P<0.01),T1、T2与T0的HR差异有统计学意义(P<0.05);T6与T0的HR差异无统计学意义(P>0.05);T6与T3～T5的HR差异有统计学意义(P<0.05)。2条犬死亡。结论丙泊酚复合麻醉在造模犬战伤救治中效果良好。

bjective To explore the method of anesthesia to cure the battle injuries, which include hepatic rupture and splenic rupture, after modeling dogs’ abdomen complex battle injury, in order to increase the survival rate in battle. Methods 10 dogs were used as experimental models by self-making tools. After mainline 3mg/kg propofol, the intervention began with pumping propofol at 12mL/h. The nasopharyngeal temperature, MAP and HR at different moments were monitored before model-making （T0）, 5min after model-making （T1）, before anesthesia induction （T2）, the moment of intubation （T3）, the moment of femoral arteriopuncture （T4）, before block and embolism （T5）,and 15min after operation （T6）. Results The nasopharyngeal temperatures during the intervention were markedly lower than T0 and T1 （P 〈 0.05）. The MAP at T0 was signifiicantly higher than T1~T5 （P 〈 0.05）. The MAP during T1~T5 was lower than that at T6 （P 〈 0.05）. The HR at T0 was significantly higher than at T3~T5 （P 〈 0.01）. The HR at T0 was higher than T1 and T2. The HR during T0 and T6 was not statistically significant （P 〉0.05）. 2 dogs were dead. Conclusion The propofol combined anesthesia haps good effects on the remedy of dog’s battle injury.