异丙酚自身复合诱导与咪唑安定、异丙酚复合诱导的临床应用比较

A clinical effects comparison of propofol auto-co-induction and midazolam propofol co-induction

目的 :比较异丙酚自身复合诱导方法 (在应用异丙酚麻醉诱导前给予 30mg小剂量异丙酚 )与咪唑安定、异丙酚复合诱导方法的临床应用效果。方法 :90例 18～ 5 5岁ASAⅠ -Ⅱ级择期手术病人随机分为M -P组 (咪唑安定、异丙酚复合诱导组 )、P -P组 (异丙酚自身复合诱导组 )和P组 (异丙酚诱导组 )。M -P组与P -P组在给予异丙酚诱导之前 ,分别给予咪唑安定 3mg、异丙酚 30mg ,P组直接应用异丙酚诱导。记录异丙酚诱导剂量、患者诱导前和气管插管前平均动脉压 (MAP)和心率(HR)。结果 :异丙酚诱导剂量 :P组为 2 .2 1mg/kg ,P -P组为 1.86mg/kg ,M -P组为 1.78mg/kg。M -P组与P组相比气管插管前平均动脉压的降低、心率的降低都明显减小。P -P组与P组相比平均动脉压的降低、心率的降低无明显差异。P -P组与M -P组相比气管插管前平均动脉压的降低、心率的降低都明显增大。结论 :异丙酚自身复合诱导方法与咪唑安定、异丙酚复合诱导方法两者均能减少麻醉诱导中异丙酚用量 ,但与咪唑安定、异丙酚复合诱导方法相比 ,异丙酚自身复合诱导方法对于维持麻醉诱导过程中血液动力学的稳定并无益处。

Objective:To compare the clinical effects of propofol auto-co-induction and midazolam propofol co-induction. Methods:90 elective operation patients of ASAⅠ-Ⅱ grade aged 18～55 years were divided randomly into three groups, M-P group(midazolam propofol co-induction group),P-P group (propofol auto-co-induction group) and P group (propofol induction group). Patients in M-P group were received midazolam 3mg, patients in P-P group were received pre-administering propofol 30 mg given as a bolus before anesthesia was induced with intravenous propofol and patients in P group were received intravenous propofol directly. Mean arterial pressure (MAP) and heart rate of all patients were monitored before induction and intubation. Results:The induction dose of propofol required in M-P group or P-P group was smaller than that of P group. The decrease in MAP and HR was significantly smaller in M-P group when compared to P group. There was no statistical difference in MAP and HR reduction between P-P group and P group. There was a significantly greater in MAP and HR decreases when P-P group was compared to M-P group. Conclusions:Either midazolam propofol co-induction or pre-administering propofol auto-co-induction can decrease the dose of propofol required to induce anesthesia, but when compared to midazolam propofol co-induction, pre-administering propofol auto-co-induction had no benefit to maintain hemodynamics stability.