2%和1%丙泊酚用于腹腔镜子宫肌瘤剔除术患者的药效学比较

Comparison of Pharmacodynamics Between 2% and 1% Propofol in Patients with Laparoscopic Myomectomy

目的比较2%与1%丙泊酚的实际药效关系,减少丙泊酚麻醉患者脂质输入过多引起的相关不良反应。方法择期行腹腔镜子宫肌瘤剔除术患者82例,采用随机数字表法分为1%丙泊酚组和2%丙泊酚组,每组41例;2组丙泊酚诱导靶控血浆浓度为4μg·m L-1,术中靶控输注丙泊酚维持麻醉,根据脑电双频指数(bispectral index,BIS)值调整丙泊酚的靶控血浆浓度,使BIS值维持在50左右(45~55);记录意识开始消失所需时间、意识消失时丙泊酚用量、苏醒时间和丙泊酚输注总量。结果 2%丙泊酚组意识开始消失所需时间、意识消失时丙泊酚用量和丙泊酚输注总量>1%丙泊酚组,苏醒时间<1%丙泊酚组,差异均有统计学意义(P<0.05);2%丙泊酚组脂剂的输入量为1%丙泊酚组的59%。结论使用2%丙泊酚靶控输注麻醉,可减少丙泊酚麻醉患者的脂质输入量,减少脂质输入过多引起的相关不良反应;2%丙泊酚的实际药效约等于1%丙泊酚的1.7倍。

OBJECTIVE To compare the pharmacodynamics between 2% and 1% propofol and reduce the related adverse reactions caused by excessive lipid input in propofol anesthesia. METHODS Eighty two patients undergoing elective laparoscopic myomectomy were randomly divided into 1% propofol group and 2% propofol group, with 41 cases in each group; Propofol was administrated with 4 μg·m L^-1 target plasma concentration during anesthesia induction and with adjusted target plasma concentration during operation according to the BIS value which was maintained at about 50（45-55） in both group. The time of consciousness loss, propofol dosage at consciousness loss, wake-up time and total amount of propofol infusion were recorded. RESULTS The time of consciousness loss, propofol dosage at consciousness loss and total amount of propofol infusion in 2% propofol group were higher than that in 1% propofol group and the wake-up time of 2% propofol group was shorter than that in 1% propofol group（P〈0.05）. The infusion of lipid dosage in 2% propofol group was 59% of that in 1% propofol group. CONCLUSION The 2% propofol used in patients undergoing propofol target controlled infusion anesthesia can reduce the infusion of lipid dosage and the related adverse events caused by excessed lipid infusion. The actual pharmacodynamics of 2% propofol is approximately equal to 1.7 times of 1% propofol during anesthesia of patients with laparoscopic myomectomy.