胃癌根治术患者实施依托咪酯TIVA对皮质醇含量的影响

Effect of etomidate TIVA on cortisol content in patients undergoing radical gastrectomy

目的:探究胃癌根治术患者实施依托咪酯全静脉麻醉(total intravenous anesthesia,TIVA)对皮质醇含量的影响。方法:将160例胃癌根治术患者作为研究对象,随机分为A组与B组各80例,分别行依托咪酯TIVA麻醉与丙泊酚麻醉,对两组患者围术期皮质醇含量变化情况以及麻醉前后患者各项生命体征进行综合评价。结果:与B组比较,A组患者麻醉后1 h、术后5 min及术后24 h皮质醇含量均降低(P <0. 05),术后48 h恢复至术前水平; A组患者麻醉后血压、心率及血氧饱和度指标均优于B组(P <0. 05)。结论:胃癌根治术患者实施依托咪酯TIVA,能够抑制围术期麻醉及创伤引起的血清皮质醇的合成,药效持久。

Objective:To explore the effect of etomidate total intravenous anesthesia(TIVA)on cortisol in patients undergoing radical gastrectomy.Methods:160 cases of patients undergoing radical gastrectomy were selected as research subjects and randomly divided into group A and group B,80 cases in each group.They were anesthetized with etomidate and propofol respectively.The changes of cortisol content during perioperative period and the vital signs of patients before and after anesthesia were evaluated comprehensively.Results:Compared with group B,cortisol levels in group A decreased significantly at 1 hour after anesthesia,5 minutes and 24 hours after operation(P<0.05),and returned to preoperative levels at 48 hours after operation.The blood pressure,heart rate and blood oxygen saturation index in group A after anesthesia were significantly better than those in group B(P<0.05).Conclusion:Etomidate TIVA in patients undergoing radical gastrectomy can inhibit the synthesis of serum cortisol caused by anesthesia and trauma during the perioperative period,and has a lasting effect.