摘要
目的探析儿童静注不同剂量丙泊酚的麻醉深度变化,对应激反应及血流动力学的影响。方法入选2012年8月~2013年12月于我院择期通过全麻进行腹部手术治疗的患儿120例,根据入院先后顺序分为两组各60例,对照组丙泊酚剂量为10 mg/（kg·h）,每20 min以10 mg/（kg·h）、8 mg/（kg·h）、6 mg/（kg·h）方案减量,观察组丙泊酚剂量为15 mg/（kg·h）,每20 min以15 mg/（kg·h）、10 mg/（kg·h）、8 mg/（kg·h）方案减量,比较两组患者在麻醉和插管各时点的血流动力学情况和脑电双频指数（B IS）,采血测定各时点血清血糖及皮质醇浓度。结果两组T0时各项血流动力学特征、BIS、血糖及皮质醇均一致,观察组各时点HR、SBP、DBP及BIS均显著低于对照组,T4时血糖值显著低于对照组,T2~T4时皮质醇显著低于对照组,差异均具有统计学意义（均P〈0.05）。结论儿童静注15 mg/（kg·h）丙泊酚能够维持较好的麻醉深度,提高循环稳定性,减轻应激反应。
Objective To discuss and analyze the changes of anesthesia depth after intravenous injection of different volume of propofol for children and its impact on stress response and haemodynamics.Methods 120 children patients about to undergo abdominal surgery under general anesthesia were chosen and divided into 2 groups,60 cases for each. The observation group received an intravenous loading dose of propofol 15 mg /（ kg·h） and reduced as 15 mg /（ kg·h）,10 mg /（ kg·h） and 8 mg /（ kg·h） every20 minutes. And the control group received an intravenous loading dose of propofol 10 mg /（ kg·h） and reduced as 10 mg /（ kg·h）,8 mg /（ kg·h） and 6 mg /（ kg·h） every 20 minutes. Haemodynamics and BIS at each time point of anesthesia and tube intubation of the 2 groups were compared,and blood glucose and corticosteroid concentration were measured by blood collection. Results Haemodynamics,BIS,blood glucose and corticosteroid of the 2 groups were in accordance with each other on baseline. HR,SBP,DBP and BIS of each time point of observation group were all obviously lower than that of the control group. Blood glucose was obviously lower than control group at T4; and corticosteroid was obviously lower than control group at T2 ~ T4（ all P〈0. 05）. Conclusion Intravenous injection of 15 mg /（ kg·h） propofol for children can maintain good depth of anesthesia,improve circulation stability and alleviate stress response.
出处
《中国现代手术学杂志》
2015年第3期237-240,共4页
Chinese Journal of Modern Operative Surgery
