不同质量浓度丙泊酚联合右美托咪定在老年腹腔镜胆囊切除术中的应用

孔明; 田云平

doi:10.11659/jjssx.12E022057

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不同质量浓度丙泊酚联合右美托咪定在老年腹腔镜胆囊切除术中的应用

临床研究 | 更新时间：2023-09-26

- 不同质量浓度丙泊酚联合右美托咪定在老年腹腔镜胆囊切除术中的应用
- Application of different concentrations of propofol combined with dexmedetomidine in elderly laparoscopic cholecystectomy
- 局解手术学杂志 2023年32卷第9期页码：804-808
- 作者机构：
  
  徐州医科大学附属徐州市立医院麻醉科，江苏徐州 221005
- 作者简介：
  
  田云平，E-mail：178673213@qq.com
- 基金信息：
  
  江苏省科学技术厅基础研究计划（自然科学基金）面上项目(BK20181145);徐州市临床技术骨干研修计划项目(2018211006)
- DOI：10.11659/jjssx.12E022057
  中图分类号： R575.6
- 纸质出版日期：2023-09-25，
  
  收稿日期：2022-12-08，
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孔明,田云平.不同质量浓度丙泊酚联合右美托咪定在老年腹腔镜胆囊切除术中的应用[J].局解手术学杂志,2023,32(09):804-808.

KONG Ming,TIAN Yun-ping.Application of different concentrations of propofol combined with dexmedetomidine in elderly laparoscopic cholecystectomy[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(09):804-808.
孔明,田云平.不同质量浓度丙泊酚联合右美托咪定在老年腹腔镜胆囊切除术中的应用[J].局解手术学杂志,2023,32(09):804-808. DOI： 10.11659/jjssx.12E022057.

KONG Ming,TIAN Yun-ping.Application of different concentrations of propofol combined with dexmedetomidine in elderly laparoscopic cholecystectomy[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(09):804-808. DOI： 10.11659/jjssx.12E022057.

摘要

目的

分析不同质量浓度丙泊酚联合右美托咪定在老年患者腹腔镜胆囊切除术中的麻醉效果。

方法

选择114例拟行腹腔镜胆囊切除术的患者，按随机数字表法分为A组、B组、C组，每组38例。麻醉药物均采用丙泊酚与右美托咪定，A组、B组、C组丙泊酚靶控输注质量浓度分别为2.0 μg/mL、3.0 μg/mL、4.0 μg/mL。对比麻醉诱导前（T

）、气管插管后5 min（T

）、气腹后5 min（T

）、气腹后15 min（T

）、气管拔管后（T

）心率、平均动脉压及血氧饱和度等血流动力学情况，比较各组麻醉优良率、麻醉后恢复情况、术中知晓情况、苏醒期的躁动发生情况及术中不良反应发生情况。

结果

血氧饱和度在组间、时间、交互方面无显著差异（

0.05）；各组T

、T

的心率、平均动脉压均较T

、T

升高（

0.05），T

时均较T

、T

降低（

0.05）；与T

相比，A组、B组T

的心率、平均动脉压均升高（

0.05）；与A组相比，B组、C组T

、T

的心率、平均动脉压均较低（

0.05），C组较B组更低（

0.05）。与A组相比，C组麻醉优良率更高（

0.05）。C组苏醒时间、定向力恢复时间、拔管时间均长于A组、B组（

0.05）；A组、B组患者均有1例出现术中知晓，C组患者没有出现术中知晓，各组术中知晓发生率比较无差异（

0.05）；C组苏醒期的躁动发生率低于A组（

0.05）；各组不良反应总发生率无显著差异（

0.05）。

结论

不同质量浓度丙泊酚联合右美托咪定在老年患者腹腔镜胆囊切除术中均有良好的麻醉效果，但丙泊酚质量浓度为4.0 μg/mL时麻醉优良率和苏醒期的躁动发生率低，而3.0 μg/mL和2.0 μg/mL丙泊酚的麻醉后恢复情况优于4.0 μg/mL。

Abstract

Objective

To analyze the anesthetic effects of different concentrations of propofol combined with dexmedetomidine in elderly patients undergoing laparoscopic cholecystectomy.

Methods

A total of 114 patients who underwent laparoscopic cholecystectomy were selected and divided into the group A， group B and group C according to the random number table method， with 38 cases in each group. Propofol and dexmedetomidine were used as the anesthetic drugs， and the target controlled infusion concentrations of propofol in the group A， group B and group C were 2.0 μg/mL， 3.0 μg/mL and 4.0 μg/mL respectively. The hemodynamics including heart rate， mean arterial pressure and blood oxygen saturation before anesthesia induction （T

）， 5 minutes after tracheal intubation （T

）， 5 minutes after pneumoperitoneum （T

）， 15 minutes after pneumoperitoneum （T

） and after tracheal extubation （T

） were compared among groups. The excellent and good rate of anesthesia， recovery after anesthesia， intraoperative awareness， occurrence of restlessness during the awakening period and occurrence of adverse reactions during operation were compared among groups.

Results

There was no significant difference in blood oxygen saturation among the groups， time or interactions （

0.05）. The heart rate and mean arterial pressure at T

and T

in each group were higher than those at T

and T

in each group （

0.05）， and those at T

were lower than those at T

and T

（

0.05）. Compared with T

， the heart rate and mean arterial pressure of T

in group A and group B were increased （

0.05）. Compared with group A， the heart rate and mean arterial pressure at T

and T

in group B and group C were decreased（

0.05）， and those in the group C were lower than those in the group B （

0.05）. Compared with the group A， the excellent and good rate of anesthesia in group C was higher （

0.05）. The recovery time， directional force recovery time and extubation time of group C were longer than those of group A and group B （

0.05）. Both group A and B had 1 case of intraoperative awareness， while patients in group C had no intraoperative awareness， and there was no significant difference in the incidence of intraoperative awareness among groups （

0.05）. The incidence of restlessness during the awakening period in group C was lower than that in the group A （

0.05）. There was no significant difference in the total incidence of adverse reactions among groups （

0.05）.

Conclusion

Different concentrations of propofol combined with dexmedetomidine have good anesthesia effect in elderly laparoscopic cholecystectomy， but the excellent and good rate of anesthesia and the incidence of restlessness during the awakening period by 4.0 μg/mL of propofolare are low， while the recovery after anesthesia by 3.0 μg/mL and 2.0 μg/mL of propofol are better than that by 4.0 μg/mL of propofol.

关键词

丙泊酚右美托咪定腹腔镜胆囊切除术麻醉效果

Keywords

propofoldexmedetomidinelaparoscopecholecystectomyanesthetic effect

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