依托咪酯乳剂在老年患者腹腔镜下全子宫切除术中麻醉效果的研究

A study of the anesthetic effects of etomidate on elderly patients undergoing laparoscopic total hysterectomy

目的 探讨依托咪酯乳剂在老年患者腹腔镜下全子宫切除术中的麻醉效果及其安全性.方法 40例择期行腹腔镜下全子宫切除术的老年患者,随机分为依托咪酯乳剂组（E组）和丙泊酚组（P组）,每组20例.E组患者使用依托咪酯乳剂进行麻醉诱导和维持;P组患者则使用丙泊酚进行麻醉诱导和维持.记录2组患者不同时间点的平均动脉压（MAP）、心率（HR）和脉搏氧饱和度（SpO2）;记录2组患者不同时间点的血浆皮质醇水平;记录2组患者手术时间、拔管时间、麻醉恢复室（PACU）治疗时间;记录2组患者围术期不良反应发生率.结果 E组患者拔管时间和PACU治疗时间显著长于P组（P〈0.05）.麻醉诱导期和麻醉维持期,E组患者MAP和HR显著高于P组（P〈0.05）;E组患者拔管后的SpO2显著高于P组（P〈0.05）.与P组相比,E组患者血浆皮质醇水平在手术结束后显著下降（P〈0.05）,但在术后24 h恢复至术前水平（P〉0.05）.E组患者注射痛发生率显著低于P组（P〈0.05）.结论 依托咪酯乳剂麻醉效果确切,且不增加围术期并发症的发生率,当用于老年患者腹腔镜下全子宫切除术的麻醉诱导和维持时安全有效.

Objective To evaluate the anesthetic effects of etomidate on elderly patients undergoing laparoscopic total hysterectomy.Methods A total of 40 patients who scheduled to undergo laparoscopic total hysterectomy were randomly divided into two groups： an etomidate group （Group E） and a propofol group （Group P） （n=20）.During surgery,Group E was treated with etomidate for anesthetic induction and maintenance,while propofol was used in Group P.Then,their heart rate （HR）,mean blood pressure （MAP）,and pulse oxygen saturation （SpO2） were recorded at different time points.The duration of operation,time of extubation and treatment time in post-anesthesia care unit （PACU） were recorded.The levels of serum cortisol were detected at different time points.The adverse reactions in both groups were recorded.Results Group E showed significantly longer time of extubation and treatment time in PACU than Group P （P〈0.05）.During anesthetic induction and maintenance,MAP and HR were markedly higher in Group E than Group P （P〈0.05）,while Group E presented markedly higher SpO2 than Group P after extubation （P〈0.05）.Compared with Group P,the level of serum cortisol in Group E was decreased significantly after surgery （P〈0.05） but returned to pre-operative level 24 h after surgery （P〉0.05）.Group E showed lower incidence of injection pain than Group P （P〈0.05）.Conclusion Etomidate is an effective anesthetic agent,and dose not result in increases in the incidence of complication,which is safe and effective for elderly patients undergoing laparoscopic total hysterectomy.