依托咪酯联合丙泊酚对全麻患者血流动力学及RNIAF的影响

Effects of etomidate combined with propofol on the hemodynamics and RNIAF of patients during general anesthesia induction

目的探讨依托咪酯联合丙泊酚在全麻诱导中的应用效果及对患者血流动力学、红细胞天然免疫黏附功能(RNIAF)的影响。方法选取辽宁省某医院2018年10月—2020年10月在气管插管全麻下行外科手术治疗的90例患者,采用随机数字表法分为对照组(50例)和观察组(40例)。对照组患者给予丙泊酚麻醉诱导,观察组在对照组基础上联合依托咪酯麻醉诱导。比较2组患者实施麻醉诱导前(T_(0))、诱导后插管时(T_(1))、插管后3 min(T_(2))、插管后10 min(T_(3))等不同时间点的血流动力学指标[心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)]、术中脑电双频指数(BIS)、RNIAF指数、术后苏醒质量指标[苏醒时间、恢复自主呼吸时间、血氧饱和度(SpO_(2))]及术后不良反应发生情况。结果观察组患者T_(1)、T_(2)、T_(3)时间点HR、MAP、SBP、DBP水平低于对照组,差异均有统计学意义(P<0.05)。2组患者不同时间点BIS及RNIAF指数比较,差异均无统计学意义(P>0.05)。2组患者术后苏醒时间、恢复自主呼吸时间及SpO_(2)水平比较,差异均无统计学意义(P>0.05)。2组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论依托咪酯联合丙泊酚进行麻醉诱导,有助于维持患者麻醉期间的血流动力学稳定及保护患者RNIAF,且对患者术后苏醒质量影响较小,安全性较高。

Objective To investigate the effects of etomidate combined with propofol in the induction of general anesthesia and its effects on the patients′hemodynamics and red cell nature immune adhesion function(RNIAF).Methods Ninety patients undergoing surgical treatment under general anesthesia with tracheal intubation in a hospital in Liaoning Province from October 2018 to October 2020 were selected and divided into a control group(50 patients)and an observation group(40 patients)using the random number table method.Patients in the control group were given propofol for induction of anesthesia,and the observation group were given etomidate combined with propofol for induction of anesthesia.The hemodynamic indexes[heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP)],intraoperative electroencephalographic bispectral index(BIS),RNIAF index and postoperative quality indicators of awakening[awakening time,time to resume spontaneous breathing,blood oxygen saturation(SpO_(2))]and the occurrence of postoperative adverse reactions were compared between the two groups before induction of anesthesia(T_(0)),at the time of intubation after induction(T_(1)),3 min after intubation(T_(2))and 10 min after intubation(T_(3)).Results The differences in HR,MAP,SBP and DBP levels at T_(1),T_(2) and T_(3) in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference between the BIS and RNIAF indices of the 2 groups at different time points(P>0.05).There was no statistically significant difference between the postoperative awakening time,time to resume spontaneous breathing and SpO_(2) level of the 2 groups(P>0.05).There was no statistically significant difference between the incidence of adverse reactions of the 2 groups(P>0.05).Conclusion Etomidate combined with propofol for induction of anesthesia can help maintain the hemodynamic balance during anesthesia and protect the RNIAF of patients,and it has relatively low impact on the quality of postoperative awakening and has a high safety.