羟考酮复合丙泊酚靶控输注麻醉在妇科腹腔镜手术中对血流动力学的影响

Effect of Target Controlled Infusion on Hemodynamics in Patients Undergoing Gynaecological Laparoscopy:Oxycodone Combined with Propofol for Anesthesia

目的探讨羟考酮复合丙泊酚靶控输注(TCI)麻醉在妇科腹腔镜手术中对血流动力学的影响。方法选择在我院2019年3月~2020年8月行妇科腹腔镜手术的85例患者作为研究对象,分为对照组(n=44)和观察组(n=41),对照组给予TCI丙泊酚麻醉,观察组给予TCI羟考酮复合丙泊酚麻醉。于麻醉诱导前(T0)、插管时(T1)、诱导后(T2)、CO_(2)气腹建立时(T3),建立后5min(T4)、拔管时(T5)、拔管后5 min(T6)记录两组患者的平均动脉压(MAP)、心率(HR)。对比两组患者苏醒时间、拔管时间及麻醉不良反应发生率。结果观察组患者的平均动脉压及心率在T3、T4时显著优于对照组,且观察组拔管时间更短,差异具有统计学意义(P<0.05);苏醒时间、麻醉不良发生率在两组之间无统计学意义(P>0.05)。结论羟考酮联合丙泊酚TCI应用于妇科腹腔镜手术中能够有效维持血流动力学稳定,安全且可靠。

Objective:To investigate the effect of target controlled infusion(TCI)on hemodynamics in patients undergoing gynaecological laparoscopy anesthetized with oxycodone combined with propofol.Methods:Totally,85 patients undergoing gynaecological laparoscopy in our hospital from March 2019 to August 2020 were selected as the objects of study.They were divided into control group(n=44)and test group(n=41).Patients in control group received TCI propofol for anesthesia,while patients in test group received TCI oxycodone combined with propofol for anesthesia.Heart rate(HR)and mean arterial pressure(MAP)were recorded at different time points[before induction of anesthesia(T0),during intubation(T1),after successful induction of anesthesia(T2),intraperitoneal CO2 insufflation(T3),after 5 minutes of intraperitoneal CO_(2) insufflation(T4),during decannulation(T5),after 5 minutes of decannulation(T6)].The awaking time of anesthesia,extubation time,and adverse reactions were compared between the two groups.Results:In the study,HR and MAP at T3,T4 in the test group were significant better than those in the control group.The time of extubation in the test group was significantly shorter than that in the control group(P<0.05).However,there were no significant differences in the awaking time of anesthesia and the incidence of adverse reactions between the two groups.Conclusions:Application of TCI oxycodone combined with propofol can maintain the stability of hemodynamics,which safety and reliability for Anesthesia in patients undergoing gynaecological laparoscopy.