| 王颖,张玲,吕宝胜,李占军.BIS监测下丙泊酚闭环靶控输注麻醉在腹腔镜全子宫切除术中的应用.[J].中南医学科学杂志.,2021,(6):713-716. |
| BIS监测下丙泊酚闭环靶控输注麻醉在腹腔镜全子宫切除术中的应用 |
| Application of closed-loop target controlled infusion anesthesia of propofol under BIS monitoring in laparoscopic hysterectomy |
| 投稿时间：2021-01-25 修订日期：2021-02-19 |
| DOI：10.15972/j.cnki.43-1509/r.2021.06.024 |
| 中文关键词: 全子宫切除术 腹腔镜 脑电双频指数 丙泊酚 闭环靶控输注 血流动力学 麻醉复苏 认知功能 |
| 英文关键词:total hysterectomy laparoscopy bispectral index propofol closed-loop target controlled infusion hemodynamics anesthesia resuscitation cognitive function |
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| 中文摘要: |
| 目的探讨脑电双频指数(BIS)监测下丙泊酚闭环靶控输注(CL-TCI)麻醉在腹腔镜全子宫切除术中的应用效果。方法回顾性分析接受腹腔镜全子宫切除术治疗的117例患者临床资料,根据不同麻醉方式分为CL-TCI组58例(BIS监测下丙泊酚CL-TCI麻醉)和TCI组59例(BIS监测下人工丙泊酚靶控输注TCI)。两组患者均监测麻醉前、手术30 min、术毕时血流动力学指标、心率(HR)、平均动脉压(MAP)、麻醉用药记录、麻醉复苏指标,同时手术前后接受认知功能评估。结果TCI组手术30 min和术毕时HR、MAP水平均较麻醉前升高；CL-TCI组各时点比较各指标均无明显变化,且手术30 min和术毕时HR、MAP水平均低于TCI组(P＜0.05)。CL-TCI组术中丙泊酚用量少于TCI组,术后自主呼吸恢复时间、苏醒时间、拔管时间均短于TCI组(P＜0.05)。两组术前MMSE评分相近(P＞0.05)；术后1天,两组MMSE均较术前降低,但CL-TCI组高于TCI组(P＜0.05)。CL-TCI组不良反应总发生率低于TCI组(P＜0.05)。结论腹腔镜全子宫切除术患者在BIS监测下行丙泊酚CL-TCI麻醉,较丙泊酚TCI更利于稳定患者的血流动力学,患者术中丙泊酚用量减少,术后早期认知功能恢复良好,麻醉复苏质量好,且可减少不良反应发生。 |
| 英文摘要: |
| to investigate the application effect of propofol closed-loop target controlled infusion (CL-TCI) anesthesia under bispectral index (BIS) monitoring in laparoscopic hysterectomy. MethodsThe clinical data of 117 patients undergoing laparoscopic hysterectomy were retrospectively collected and analyzed. According to different anesthesia methods, they were divided into CL-TCI group with 58 cases, propofol CL-TCI anesthesia under BIS monitoring and TCI group with 59 cases, propofol target controlled infusion (TCI) under BIS monitoring; All patients received hemodynamic monitoring before anesthesia, 30 min after operation, and at the end of operation, heart rate (HR), mean arterial pressure (map), evaluation of anesthesia recovery indexes. ResultsThe levels of HR and map at 30 min after operation－at the end of operation in TCI group were higher than those at before anesthesia, and there was no significant change in each index at each time point in CL-TCI group, and the levels of HR and map at 30 min after operation－at the end of operation were lower than those in TCI group (P＜0.05); The amount of propofol used during operation in CL-TCI group was less than that in TCI group, and the recovery time of spontaneous breathing, recovery time and extubation time after operation in CL-TCI group were shorter than those in TCI group (P＜0.05); The preoperative MMSE scores of the two groups were similar (P＞0.05); On the 1st day after operation, MMSE in both groups was lower than that before operation, but the MMSE in CL-TCI group was higher than that in TCI group (P＜0.05); The total incidence of adverse reactions in CL-TCI group was lower than that in TCI group (P＜0.05). ConclusionsCompared with propofol TCI, propofol CL-TCI anesthesia under BIS monitoring is more conducive to the stability of hemodynamics in patients undergoing laparoscopic hysterectomy.The dosage of propofol during operation is reduced, the early postoperative cognitive function recovery is good, the quality of anesthesia recovery is good, and the occurrence of adverse reactions can be reduced. |
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