异丙酚复合瑞芬太尼全身麻醉对前列腺癌根治术患者眼内压和眼灌注压的影响

Effects of propofol combined with remifentanil general anesthesia on intraocular pressure and intraocular perfusion pressure in patients undergoing radical prostatectomy

目的研究前列腺癌根治术患者麻醉中异丙酚复合瑞芬太尼全身麻醉方式对其眼内压、眼灌注压的影响。方法64例前列腺癌根治术患者,根据不同麻醉方式分为对照组和研究组,每组32例。对照组行七氟烷复合瑞芬太尼全身麻醉,研究组行异丙酚复合瑞芬太尼全身麻醉。比较2组患者不同时间点(诱导前、插管后5 min、建立头低臀高截石体位及气腹30 min、建立头低臀高截石体位及气腹90 min、停气腹平卧后15 min、手术完成60 min)的麻醉深度指数、呼吸末二氧化碳、潮气量、平均动脉压与眼内压、眼灌注压。结果2组不同时间点的麻醉深度指数、呼吸末二氧化碳、潮气量、平均动脉压差异无统计学意义(P>0.05)。2组诱导前、插管后5 min、停气腹平卧后15 min、手术完成60 min时间点的眼内压、眼灌注压差异无统计学意义(P>0.05);研究组较对照组建立头低臀高截石体位及气腹30 min、90 min时间点的眼内压更低,眼灌注压更高(P<0.05)。结论前列腺癌根治术患者麻醉中异丙酚复合瑞芬太尼全身麻醉方式的应用效果显著,可有效改善患者的眼内压及眼灌注压。

Objective To investigate the effects of propofol combined with remifentanil general anesthesia on intraocular pressure and intraocular perfusion pressure in patients undergoing radical prostatectomy.Methods A total of 64 patients who underwent radical prostatectomy in our hospital from March 2018 to June 2019 were enrolled in the study,who were divided into control group and research group according to different anesthesia ways,with 32 cases in each group.The patients in control group were treated by general anesthesia with sevoflurane combined with remifentanil,however,the patients in research group were treated by general anesthesia with propofol combined with remifentanil.The depth of anesthesia index,end-inspiratory carbon dioxide,tidal volume,mean arterial pressure,intraocular pressure(IOP)and intraocular perfusion pressure(IPP)were observed and compared between the two groups at different time points(before induction,5min after intubation,30min after establishment of head-low-hip high-stone posture and pneumoperitoneum,90min after establishment of head-low-hip high-stone posture and pneumoperitoneum,15min after suspension of pneumoperitoneum,60min after operation).Results There were no significant differences in depth index of anesthesia,carbon dioxide inhalation,tidal volume and mean arterial pressure between the two groups(P>0.05).There were no significant differences in the levels of IOP and IPP before induction,5min after intubation,15min after lying flat on the ground after stopping pneumoperitoneum,and 60min after operation between the two groups(P>0.05).As compared with those in control group,the IOP levels at 30min and 90min after establishment of head-low-hip high-stone posture and pneumoperitoneum in research group were significantly lower than those in control group,however,the IPP levels in research group were significantly higher than those in control group(P<0.05).Conclusion The application of propofol combined with remifentanil in general anesthesia for patients undergoing radical prostatectomy is effective in improving intraocular pressure and intraocular perfusion pressure of patients.