首页|丙泊酚与七氟烷麻醉时二氧化碳气腹对腹腔镜子宫切除术患者BIS及氧代谢的影响

丙泊酚与七氟烷麻醉时二氧化碳气腹对腹腔镜子宫切除术患者BIS及氧代谢的影响

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目的 分析丙泊酚与七氟烷麻醉时二氧化碳气腹对腹腔镜子宫切除术患者脑电双频指数(Bispectral index,BIS)及氧代谢的影响.方法 选取山东大学第二医院100例行腹腔镜子宫切除术患者,分为A组行丙泊酚和B组行七氟烷麻醉,每组各50例.对比2组患者气腹前后氧代谢指标的情况.结果 2组PETCO2气腹后各时间点均明显高于气腹前(P<0.05),气腹后不同时间点的SpO2与气腹前对比,并无明显差异;A组气腹后40 min的HR、MAP均明显低于B组(P<0.05),2组间PETCO2、SpO2对比差异无统计学意义.2组患者BIS在气腹前后均维持平稳状态.组内各时段相比差异无统计学意义;2组患者的CjvO2、Lac含量相较气腹前均显著上升(P均<0.05),CaO2、CERO2、Da-jvO2水平相较气腹前均显著降低(P均<0.05);A组气腹后40 min的CjvO2高于B组(P<0.05),CERO2、Da-jvO2水平低于B组(P<0.05),而2组的BIS、CaO2以及Lac含量对比均无明显差异.结论 腹腔镜子宫切除术患者二氧化碳气腹能够影响BIS和氧代谢,丙泊酚比七氟烷对二者的影响更为显著.
Effects of carbon dioxide pneumoperitoneum on BIS and oxygen metabolism in patients underwent laparoscopic hysterectomy in propofol and sevoflurane anesthesia
Objective To study the influence of carbon dioxide pneumoperitoneum on BIS and oxygen metabolism in patients underwent laparoscopic hysterectomy in propofol and sevoflurane anesthesia. Methods 100 cases undergoing laparoscopic hysterectomy were selected in the second hospital of Shandong university and were divided into group A and group B, 50 cases in each group. Group A were received propofol and group B were received sevoflurane anesthesia . The oxygen metabolism index in the two groups were compared before and after pneumoperitoneum. Results The PETCO2 of two groups at the time points after pneumoperitoneum were significantly higher than those before pneumoperitoneum (P<0.05). There was no significant difference of the SpO2 in two groups at the different time points during pneumoperitoneum, The HR and MAP of the group A were significantly lower than that of group B (P<0.05). There were no significant difference of the PETCO2、SpO2 between two groups. Bis in 2 groups maintained a stationary state before and after pneumoperitoneum. There was no significant difference in the period between the two groups. The CjvO2、Lac of two groups were significantly higher than that before pneumoperitoneum (all P<0.05).The CjvO2、Lac of two groups were significantly lower than that before pneumoperitoneum (all P<0.05). The CjvO2 of group A at 40 minutes after pneumoperitoneum were higher than that of group B (P<0.05), and the level of CERO2、Da-jvO2 were lower than that of group B (P<0.05). But there were no difference of the BIS、CaO2 and Lac between two groups. Conclusion Carbon dioxide pneumoperitoneum can affect the BIS and oxygen metabolism in patients underwent laparoscopic hysterectomy. The effect in propofol anesthesia was more significant than that in sevoflurane anesthesia.

propofolsevofluranepneumoperitoneumoxygen metabolism

张贺、金延武、赵鑫

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山东大学第二医院 麻醉科,山东 济南 250033

丙泊酚 七氟烷 气腹 氧代谢

山东省科技厅自然科学基金

ZR2013HL022

2017

中国生化药物杂志
南京生物化学制药研究所,全国生化制药情报中心站,中国生化制药工业协会,中国药品生物制品检定所

中国生化药物杂志

ISSN:1005-1678
年,卷(期):2017.37(8)
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