摘要
【目的】探讨异丙酚靶控输注(TCI)用于肥胖人群的可行性。【方法】将本院80例行腹腔镜胆囊切除术患者根据体质量指数(BMI)不同分为两组,正常体质量组(BMI〈25kg/m2)38例,肥胖组(BMI30~40kg/m2)42例,两组均静脉注射芬太尼2~3μg/kg,靶控输注异丙酚,异丙酚初始血浆靶浓度(Ct)为3.0μg/mL,达到血浆靶浓度30s后增加0.3μg/mL,OAA/S评分=1分后静脉注射罗库溴铵0.6mg/kg,2min后进行气管插管;记录比较两组各阶段异丙酚Ct的脑电双频谱指数(BIS)值、麻醉时间、手术时间和苏醒时间。【结果】两组手术时间及麻醉时间相比较差异无显著性(P〉0.05),肥胖组苏醒时间较正常体质量组延长,且两组比较差异有显著性(P〈0.05)。两组患者异丙酚D与BIS值均呈负相关(P〈0.05),但肥胖患者的相关程度要显著低于正常体质量患者,且两组相比较差异有显著性(P〈0.05)。【结论】异丙酚TCI可用于肥胖患者,但是较正常体质量患者且性能相对降低。
[Objective]To investigate the feasibility and prospects of target controlled infusion (TCI) with propofol on obese subjects. [MethodslEighty patients were divided into two groups according to the BMI index: the normal weight group (BMI -〈 25 kg/m2), and the obese weight group (BMI 30~40 kg/m2 ). Fentanyl was intravenous 2~3 μg/kg, and propofol was given by target controlled infusion method. The initial target plasma concentration of propofol was set at 3.0 μg/mL. After the target concentration was steadily maintained for 30s, it was increased 0.3μg/mL. Intravenous 0.6 mg/kg of rocuronium was added when OAA/S score was 1 point and tracheal intubation was performed 2 minutes later. Brain bispectral index (BIS) in every stage of propofol target plasma concentration (Ct) , anesthesia time, operation time, and recovery time of all the patients were recorded. [ResultslThere were no statistically significant differences on surgery and anesthesia time between the two groups ( P D0.05), the obese group, however, did have longer awakening time than normal weight group ( P 〈0.05). Propofol Ct and BIS value were both inversely proportional in the two groups of patients ( P〈0.05), but the correlation of obese patients was lower than normal weight patients ( P 〈0.05). [Conclusion]Propofol TCI can be used in obese patients during surgery, but the performance will be reduced.
出处
《医学临床研究》
CAS
2016年第5期948-949,952,共3页
Journal of Clinical Research