不同剂量丙泊酚对儿童麻醉深度和应激反应的影响

Effects of different doses of propofol on anesthesia depth of anesthesia and stress response in children

目的探究不同剂量丙泊酚对儿童麻醉深度、应激反应的影响。方法选取2019年4月至2021年4月于本院儿科行手术治疗的80例患儿作为研究对象,根据丙泊酚剂量不同分为对照组与实验组,每组40例。对照组给予丙泊酚6mg/(kg·h)进行麻醉,实验组给予丙泊酚10mg/(kg·h)进行麻醉,比较两组不同时间血压和心率(HR)、脑电双频指数(BIS)及不良反应发生率。结果两组舒张压(DBP)、收缩压(SBP)、HR组间、时间、交互比较差异有统计学意义(P<0.05);麻醉诱导前(T0)时,两组DBP、SBP、HR比较差异无统计学意义;诱导插管前(T1)、插管后即刻(T2)、切皮时(T3)、拔管时(T4),实验组DBP、SBP、HR均低于对照组,差异有统计学意义(P<0.05)。两组BIS组间、时间、交互比较差异有统计学意义(P<0.05);T0时,两组BIS比较差异无统计学意义;T1、T2、T3、T4时,实验组BIS均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论选择10mg/(kg·h)剂量的丙泊酚对患儿行麻醉维持效果较好,其对患儿的血压及HR影响较小,还可维持较好的麻醉深度,且安全性较高,可作为儿科手术中丙泊酚的首选剂量。

Objective To explore the effects of different doses of propofol on anesthesia depth of anesthesia and stress response in children.Methods A total of 80 children who received surgical treatment in the department of Pediatrics of our hospital from April 2019 to April 2021 were se-lected as the research subjects,and they were divided into control group and experimental group according to different doses of propofol,with 40 cases in each group.The control group was given propofol 6 mg/(kg·h)for anesthesia,and the experimental group was given propofol 10 mg/(kg·h)for an-esthesia,the blood pressure,heart rate(HR),bispectral index(BIS)at different times,and the incidence of adverse reactions were compared between the two groups.Results There were significant differences in diastolic blood pressure(DBP),systolic blood pressure(SBP),HR between groups,time and interaction between the two groups(P<0.05);before anesthesia induction(T0),there were no significant differences in DBP,SBP and HR be-tween the two groups;before induction intubation(T1),immediately after intubation(T2),cuticle resection(T3),extubation(T4),DBP,SBP and HR in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05).There were significant differences in BIS between groups,time and interaction between two groups(P<0.05);at T0,there was no significant difference in BIS between the two groups;at T1,T2,T3,and T4,BIS in the experimental group were lower than those in the control group,and the differences were statistically sig-nificant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion 10 mg/(kg·h)dose of propofol has good effect on the maintenance of anesthesia in children,and has little influence on the blood pressure and HR of children,can also maintain good depth of anesthesia with high safety,and can be used as the preferred dose of propofol in pediatric surgery.