丙泊酚靶控全身输注麻醉在骨外伤危重患者急诊中的应用

Application of propofol target controlled infusion general anesthesia to emergency treatment on critical patients with bone trauma

目的探讨丙泊酚靶控全身输注麻醉在骨外伤危重患者急诊中的应用效果。方法将骨外伤急诊危重患者120例随机分为治疗组60例与对照组60例,治疗组选择丙泊酚靶控输注全麻,对照组选择七氟烷吸入全麻,观察两组围手术期的相关指标变动情况,并对麻醉恢复情况进行观察。结果所有患者都完成手术,所有患者的平均动脉压(MAP)与心率(HR)在诱导后2 min与诱导前比较明显降低(P<0.05),而MAP和HR在组间比较无统计学差异(P>0.05),其余时间点的上述值在组内与组间比较均无统计学差异(P>0.05)。术后两组的头晕、恶心呕吐、皮肤瘙痒等不良反应发生率对比差异都无统计学意义(P>0.05)。两组诱导后IL-2都呈现明显下降的趋势,但诱导后治疗组的IL-2都明显高于对照组(P<0.05);两组不同时间点的s IL-2R在组内与组间对比差异都无统计学意义。治疗组的自主呼吸恢复时间、睁眼及应答时间都明显短于对照组(P<0.05)。结论相对于吸入全麻,丙泊酚靶控输注全麻在骨外伤危重患者急诊中的应用能缩短麻醉后恢复期自主呼吸恢复、睁眼及应答时间,值得推广应用。

Objective To investigate the application effects of propofol target controlled infusion general anesthesia on the emergency treatment for critical patients with bone trauma. Methods 120 critical patients with bone trauma were randomly and equally divided into treatment group and control group. The treatment group was given the propofol target controlled infusion general anesthesia,and the control group was given the inhalation general anesthesia with sevoflurane. Observation was made in the changes of perioperative indicators and anesthesia recovery between the two groups. Results The surgeries were completed in all the patients. Their MAP and HR significantly decreased 2 min after the induction compared with those before the induction（P〈 0.05）, while the differences in MAP and HR between the two groups were not significant（P〉 0.05）. The differences in MAP and HR at other time points between the two groups were not significant（P〉 0.05）. And the differences in the incidence of adverse reactions like dizziness, nausea and vomiting,and skin itch between the two groups were not significant（P〉 0.05）. After the treatment, the IL-2 in both groups decreased, but that of the treatment group was significantly higher than that of the control group after the induction（P〈 0.05）. The differences in s IL-2R at different time points within the groups or between the two groups were not significant. The spontaneous breathing recovery time, eyes opening time point, and response time of the treatment group were significantly less than those of the control group（P〈 0.05）.Conclusion Compared with inhalation gen eral anesthesia, the application of propofol target controlled infusion general anesthesia to emergency treatment on critical patients with bone trauma can shorten the spontaneous breathing recovery time, eyes opening time,and response time after the anesthesia. It is worthwhile to be promoted.