国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2011, Vol. 30 ›› Issue (6): 444-445.

• 论著 • 上一篇    下一篇

依托咪酯用于妇科腹腔镜手术全麻诱导时的临床研究

吕东东, 袁 峰   

  1. 450007 郑州市中心医院麻醉科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2011-11-15 发布日期:2011-11-15

Clinical Study of Etomidate During Induction of General Anesthesia on Laparoscopic Operation of Gynecology

LU Dong-dong， YUAN-Feng   

  1. The Anesthesiology Department of Central Hospital of Zhengzhou，Zhengzhou 450007， China
  • Received:1900-01-01 Revised:1900-01-01 Published:2011-11-15 Online:2011-11-15

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摘要： 目的：比较依托咪酯与异丙酚在妇科腹腔镜手术全麻诱导时对患者循环系统的影响。方法：选择美国麻醉师协会（American Society of Anesthesiologists，ASA）分级标准中的Ⅰ~Ⅱ级，行妇科腹腔镜手术患者60例，随机分为2组，每组30例。其中依托咪酯组（E组）：咪达唑仑0.05 mg/kg，芬太尼2~3 μg/kg，依托咪酯0.2 mg/kg，顺苯磺酸阿曲库铵0.15 mg/kg；异丙酚组（P组）：咪达唑仑0.05 mg/kg，芬太尼2~3 μg/kg，异丙酚1 mg/kg，顺苯磺酸阿曲库铵0.15 mg/kg，依次静脉注射。分别记录2组心率（HR）、动脉收缩压（SBP）、动脉舒张压（DBP）的诱导前（T0）、诱导后（T1）、插管即刻（T2）及插管后1 min（T3）、3 min（T4）、5 min（T5）时的数值；并于T0，T4和T5检测血浆去甲肾上腺素（NE）浓度。结果：2组T0时的HR，SBP和DBP相比较，差异无统计学意义（P＞0.05）。诱导过程中2组的HR，SBP和DBP均出现一过性增高，差异有统计学意义（P＜0.05）。E组T4和T5时的血浆NE浓度均低于P组，差异有统计学意义（P＜0.05）。结论：针对妇科腹腔镜手术患者，依托咪酯全麻诱导时血流动力学比异丙酚诱导更加稳定。

关键词: 依托咪酯, 二异丙酚, 麻醉药, 全身, 血流动力学, 去甲肾上腺素

Abstract: Objective： To compare the effects of etomidate and propofol on circulatory system during induction of general anesthesia on laparoscopic operation of gynecology. Methods： Sixty patients of laparoscopic operation of gynecology, at Ⅰ～Ⅱselected by ASA， ｗere randomly and equally divided into two groups. Etomidate group（E group） were treated with midazolam 0.05 mg/kg, fentanyl 2~3 μg/kg, etomidate 0.2 mg/kg, cis?鄄atracurium 0.15 mg/kg; propofol group（P group） with midazolam 0.05 mg/kg, fentanyl 2~3 μg/kg and propofol 1 mg/kg, cis-atracurium 0.15 mg/kg. Drugs were transfused by intravenous injection. Heart rate （HR）， systolic blood pressure（SBP） and diastolic blood pressure（DBP） were recorded before induction （T0）, after induction（T1）, intubation（T2） and after intubation 1（T3）， 3（T4）， 5（T5） min. The concentration of plasma norepinephrine（NE） was analysed on T0， Ｔ４，Ｔ5. Results：①The differences of HR， SBP and DBP on T0 between two groups were not statistically significant（P＞0.05）, while the differences of three parameters on T1 of the P group were statistically significant when respectively compared with those on T0 （P＜0.05）. ②HR，SBP and DBP of the two groups on T2 were significantly higher than those on T1（P＜0.05）, meanwhile three parameters on T2 ， T3 were significantly higher than those on T4（P＜0.05）.③NE level of E group on T4 and T5 were significantly higher than those of P group（P＜0.05）. Conclusions： Etomidate in patients as inducing general anesthesia for laparoscopic operation of gynecology has more stable hemodynamics than propofol.

Key words: Etomidate, Propofol, Anesthetics, general, Hemodynamics, Norepinephrine