[1]谈世刚,鲁汉杰,余　挺,等.不同异丙酚诱导麻醉对颅内假性动脉瘤介入治疗气管插管期心血管反应的影响[J].中国临床神经外科杂志,2019,(04):218-220.[doi:10.13798/j.issn.1009-153X.2019.04.009]
　TAN Shi-gang,LU Han-jie,YU Ting,et al.Effects of anesthesia induction with different methods of infusion of propofol on cardiovascular response in patients with pseudoaneurysms during tracheal intubation[J].,2019,(04):218-220.[doi:10.13798/j.issn.1009-153X.2019.04.009]
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不同异丙酚诱导麻醉对颅内假性动脉瘤介入治疗气管插管 期心血管反应的影响()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年04期
页码:
218-220
栏目:
论著
出版日期:
2019-04-27

文章信息/Info

Title:
Effects of anesthesia induction with different methods of infusion of propofol on cardiovascular response in patients with pseudoaneurysms during tracheal intubation
文章编号:
1009-153X（2019）04-0218-03
作者:
谈世刚; 鲁汉杰; 余　挺; 甘国胜; 宋晓阳
430070 武汉，中国人民解放军中部战区总医院麻醉科（谈世刚、鲁汉杰、余　挺、甘国胜、宋晓阳）
Author(s):
TAN Shi-gang;  LU Han-jie;  YU Ting;  GAN Guo-sheng;  SONG Xiao-yang.
Department of Anesthesia, General Hospital, Central Theater of the Chinese people’s Liberation Army, Wuhan 430070, China
关键词:
颅内假性动脉瘤; 介入治疗; 麻醉诱导; 异丙酚; 靶控输注; 气管插管
Keywords:
Intracranial pseudoaneurysms;  Different infusion;  Interventional therapy;  Tracheal intubation;  Induction anesthesia
分类号:
R 743.9; R 614.2
DOI:
10.13798/j.issn.1009-153X.2019.04.009
文献标志码:
A
摘要:
目的 观察异丙酚不同输注法行麻醉诱导对颅内假性动脉瘤介入治疗气管插管期心血管反应的影响。方法 选择2010年6月至2018年5月血管内介入治疗的颅内假性动脉瘤60例，根据麻醉诱导方 法分为三组：单次静脉推注组（A组）、血浆靶控组（B组）和效应室靶控组（C组），每组20例。麻醉诱导方法：A组采用异丙酚2 mg/kg单次静脉推注；B组设定异丙酚血浆靶浓度为4 μg/ml；C组设定异 丙酚效应室靶浓度4 μg/ml。三组均同时采用瑞芬太尼4 ng/ml血浆靶浓度靶控输注诱导，待意识消失后静注罗库溴铵0.6 mg/kg，脑电双频谱指数在40~60并维持5s时行气管插管。记录进入手术室（T0） 、喉镜暴露声门（T1）、气管导管过声门（T2）、气管导管进入气管后1 min（T3）、2 min（T4）、3 min（T5）平均动脉压（MAP）、心率（HR）；并记录气管插管期不良反应及纠正次数。结果 与T0比 较，三组T1~T3 MAP均明显降低（P<0.05），三组T1~T5 HR均明显减慢（P<0.05）；与B组比较，A组与C组T1 MAP明显降低（P<0.05）、HR明显减慢（P<0.05）。B组低血压、心动过缓等发生率和纠正次数 明显少于A组（P<0.05），而且B组心动过缓发生率和纠正次数少于C组（P<0.05）。C组纠正次数明显少于A组（P<0.05）。结论 4 μg/ml异丙酚血浆药物浓度作为目标靶控输注浓度更适合颅内假性动脉 瘤介入治疗的麻醉诱导，低血压和心动过缓不良反应等发生率更低。
Abstract:
Objective To observe the effect of anesthesia induction with different methods of infusion of propofol on cardiovascular response during endotracheal intubation during interventional therapy in patients with intracranial pseudoaneurysms. Methods Sixty patients with intracranial pseudoaneurysm undergoing interventional therapy were divided into three groups of 20 patients each, i.e. in group A (single intravenous injection of propofol), group B (target-controlled plasma concentration of propofol: 4 μg/ml) and group C (target-controlled effect site concertration: 4 μg/ml). All three groups anesthesia were induced by target-controlled infusion of remifentanil (target-controlled plasma concentration was 4 ng/ml) in all the groups. Rocuronium 0.6 mg/kg was injected intravenously after the patient’s consciousness disappeared. Tracheal intubation was performed when the bispectral index kept between 40 and 60 for 5 seconds. The mean arterial pressure (MAP) and heart rate (HR) were recorded at the time of entering the operating room (T0), immediately after exposure of the glottis with laryngoscope (T1), immediately after tracheal tube passing through the glottis (T2) and 1 minute (T3), 2 minutes (T4) and 3 minutes (T5) after tracheal tube entering the trachea the incidence and correction times of adverse reactions during tracheal intubation were recorded. Results MAP significantly decreased at T1, T2 and T3, HR slowed significantly at T1, T2, T3, T4 and T5 in all the groups (P<0.05) compared with those at T0. MAP was significantly lower and HR was significantly slower in groups A and C than those in group B at T1 (P<0.05). The incidences of hypotension and bradycardia and the number of their correction in group B were significantly lower than those in group A (P<0.05) and the number of correction in group C was significantly lower than that in group A (P<0.05). The incidence and number of correction of bradycardia in group B were significantly lower than those in group C (P<0.05). Conclusions The plasma concentration of 4 μg/ml propofol as the target-controlled infusion concentration is more suitable for anesthesia induction in patients with intracranial pseudoaneurysms undergoing interventional therapy, and the incidence of the adverse reactions including hypotension and bradycardia is significantly lower.

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备注/Memo

备注/Memo:
（2018-09-27收稿，2019-02-02修回） 通讯作者：甘国胜，E-mail：526193186@qq.com 页码220+223
更新日期/Last Update: 2019-04-27