比较七氟醚与丙泊酚对麻醉诱导期自主神经功能的改变

Effects of sevoflurane and propofol anesthetics on changes of autonomic nerve function during induction of anesthesia

目的比较七氟醚与丙泊酚对麻醉诱导期自主神经功能的影响。方法 80例手术治疗患者随机分为两组,麻醉诱导分别给予七氟醚(七氟醚组)与丙泊酚(丙泊酚组),观察麻醉前10 min(T0)、麻醉诱导后即刻(T1)、插管即刻(T2)、插管后5 min(T3)时间血压、心率、心率变异性等。结果七氟醚组T1、T2呼吸频率、收缩压、舒张压均低于麻醉前(P<0.05),丙泊酚组T1、T2、T3呼吸频率、收缩压、舒张压均低于麻醉前(P<0.05),且丙泊酚组较七氟醚组下降更明显(P<0.05)。七氟醚组T1、T2、T3心率较麻醉前均下降(P<0.05),丙泊酚组心率变化不明显(P>0.05),七氟醚组均低于丙泊酚组(P<0.05);七氟醚组与丙泊酚组T1、T2总频、低频、高频均较麻醉前低(P<0.05),且七氟醚组均低于丙泊酚组(P<0.05);丙泊酚组T1、T2、T3低高频比值均高于麻醉前(P<0.05),七氟醚组低高频比值变化不明显(P>0.05),且七氟醚组均低于丙泊酚组(P<0.05)。结论七氟醚与丙泊酚均可以有效进行麻醉诱导,其中七氟醚吸入麻醉对血流动力学影响比较小,麻醉诱导相对平稳。

【Objective】To investigate the effects of sevoflurane and propofol anesthetics on the autonomic nerve function during induction of anesthesia.【Methods】Eighty patients with surgical treatment were included. All the patients were divided into two groups, and some were given sevoflurane anesthesia（sevoflurane group） and others given propofol（propofol group）. The systolic pressure, diastolic blood pressure, heart rate, heart rate variability were observed 10 min before anesthesia（T0）, immediately after induction of anesthesia（T1）, immediately after intubation（T2）, 5 min after intubation（T3）.【Results】The breathing rate, the systolic pressure and the diastolic pressure in the sevoflurane group at T1, T2 were lower than those before anesthesia（P〈0.05）. The breathing rate, the systolic pressure and the diastolic pressure in the propofol group at T1, T2, T3 were lower than those before anesthesia（P〈0.05）,which decreased more significantly in the propofol group than in the sevoflurane group（P〈0.05）. The heart rate in the sevoflurane group significantly decreased at T1, T2, T3 compared to that before anesthesia（P〈0.05）. But heart rate changes in the propofol group were not obvious（P〉0.05）, which were higher in the propofol group than in the sevoflurane group（P〈0.05）. The total frequency, the low frequency and the high frequency in the sevoflurane and the propofol groups at T1, T2 were lower than those before anesthesia（P〈0.05）, which were lower in the sevoflurane group than in the propofol group（P〈0.05）. The low/high frequency ratio in the propofol group at T1, T2, T3 were higher than those before anesthesia（P〈0.05）, but had no obvious changes in the sevoflurane group（P〉0.05）, which were lower in the sevoflurane group than in the propofol group（P〈0.05）.【Conclusions】Compared to target propofol, induction of anesthesia with sevoflurane has 1ess effect on hemodynamics of patients.