| 乐园 李杨 苏勋玲 童建斌 李莉.BIS监测下丙泊酚靶控静脉麻醉与七氟醚麻醉效果比较[J].,2016,16(27):5380-5382 |
| BIS监测下丙泊酚靶控静脉麻醉与七氟醚麻醉效果比较 |
| Anesthesia Effects Comparison Between Total Intravenous Anesthesia UsingPropofol Target-Controlled Infusion and Sevoflurane Intravenous-InhalationCombined Anesthesia Guided by Bispectral Index |
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| DOI： |
| 中文关键词: 脑电双频指数 靶控输注 全凭静脉麻醉 静吸复合麻醉 |
| 英文关键词: BIS Target-controlled infusion Total intravenous anesthesia Intravenous-inhalation anesthesia |
| 基金项目:国家自然科学基金项目（81400896；81471107） |
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| 中文摘要: |
| 目的：比较BIS 监测下丙泊酚靶控输注全凭静脉麻醉与七氟醚静吸复合麻醉两种方式下的腹腔镜下子宫切除手术患者麻
醉效果。方法：46 例择期腹腔镜下子宫切除患者，ASAI`II 级，随机分为：丙泊酚靶控全凭静脉麻醉组（TCI组）和七氟醚静吸复合
麻醉组（SD 组），各23 例。术中均监测BIS 值(维持在40~60)。记录麻醉诱导前（T1）、手术开始30 min（T2）、术后1 h（T3）患者血压
（BP）和心率(HR)；记录术后自主呼吸恢复时间、睁眼时间、拔管时间；记录术中知晓发生率和术后24 小时恶心呕吐（PONV）发生
率。结果：TCI 组与SD组患者BP 和HR在T1、T2、T3 各时间点比较差异均无统计学意义（P > 0.05）；TCI组呼吸恢复时间、睁眼
时间、拔管时间均早于SD 组，差异有统计学意义（P<0.05）；两组患者均未发生术中知晓；但术后24 小时PONV 发生率TCI 组明
显低于SD 组（P<0.05）。结论：在BIS 监测下，丙泊酚靶控全凭静脉麻醉与七氟醚静吸复合麻醉用于腔镜下子宫切除手术均能够
维持术中患者血流动力学平稳，预防术中知晓，但全凭静脉麻醉较静吸复合麻醉患者术后恢复更快，术后24 小时恶心呕吐发生
率低。 |
| 英文摘要: |
| Objective:To compare the anesthesia effects for patients with laparoscope hysterectomy between the total intravenous
anesthesia using Propofol target-controlled infusion and Sevoflurane intravenous-inhalation combined anesthesia guided by bispectral index.Methods:In this study, 46 patients, at ASA Ⅰ -Ⅱ grade, would get selected laparoscope hysterectomy were recruited. They were
randomly divided into two groups: total intravenous anesthesia using Propofol target-controlled infusion group (TCI group) and Sevoflurane
intravenous-inhalation combined anesthesia (SD group). BIS was monitored for every patient. Hemodynamic parameters including
blood pressure(BP) and heart rate(HR) were observed before anesthesia induction, at 30 min after the beginning of operation and 1 h after
the end. The incidence of intraoperative awareness in the patients was observed. And the inducing time, recovery time of spontaneous
breathing, eye opening time and extubation time were recorded. The 24h postoperative nausea and vomiting (PONV) of the patients were
observed after operation.Results:No statistical differences were observed in blood pressure and heart rate at each time point between
TCI group and SD group (P>0.05). There was no case of intraoperative awareness in the two groups. The recovery time of spontaneous
breathing, eye opening time and extubation time in TCI group all were earlier than in SD group, and the differences were statistically significant
(P<0.05). In addition, the incidence of 24 h PONV was significantly lower in TCI group than in SD group (P< 0.05).Conclusion:The total intravenous anesthesia using Propofol target-controlled infusion and Sevoflurane intravenous-inhalation combined anesthesia
guided by bispectral index both were perfectly safe and could prevent against intraoperative awareness for the patients with laparoscope
hysterectomy. But patients with total intravenous anesthesia using target-controlled infusion got faster anesthesia recovery and
lower incidence of 24 h postoperative nausea and vomiting. |
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