丙泊酚与七氟烷全麻对梗阻性黄疸患者影响的比较

摘要

Objective To compare the anesthesia of Propofol target controlled infusion and Sevollurane inhalation anes thesia recovery time and recovery of patients with obstructive jaundice of the bispectral index (BIS),the influence of adverse reactions and postoperative extubation time.Methods From January 2016 to May 2017,72 patients of general anesthesia on downward abdominal surgery in Maoming Hospital of Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,all were ASA Ⅰ or Ⅱ,according to the serum level of total bilirubin they were divided into jaundice group and non jaundice group,with 36 cases in each group,then the jaundice group and non jaundice group were randomly divided into Propofol group A,B and Sevoflurane group A,B,with 18 cases in each group.The awakening time,BIS,extubation time and postoperative adverse reaction of each groups were recorded.Results The recovery time,BIS,and extubation time of patients in the Sevoflurane group A were the longest,the recovery time,BIS at recovery time and extubation time of patients in the Propofol group A were significantly shorter than those in Sevoflurane group A,the differences were statistically significant (P ＜ 0.05).BIS,recovery time and extubation time of patients in the Propo fol group B were longer than those of the Sevoflurane group B,the differences were statistically significant (P ＜ 0.05).The incidence of PONV,dizziness and drowsiness 24 h after surgery of patients in the Propofol group B was significantly lower than that in the Sevoflurane group B,and the incidence of PONV,dizziness and drowsiness 24 h after surgery in the Propofol group A was lower than that in the Sevoflurane group A,the differences were statistically significant (P ＜ 0.05).Conclusion Propofol target controlled infusion anesthesia has a lower rate of PONV and more rapid recovery compared with Sevoflurane patients with obstructive jaundice,and the anesthetic effect of Propofol is better than that of Sevoflurane.%目的 比较在全麻术中丙泊酚靶控输注与七氟烷吸入麻醉对梗阻性黄疸患者的苏醒时间、苏醒时脑电双频指数(BIS)、拔管时间及发生术后不良反应的影响.方法 选择2016年1月～2017年5月于广州中医药大学附属茂名市中医院全身麻醉下行上腹部手术的患者72例,均为ASA Ⅰ或Ⅱ级.按血清总胆红素水平分为黄疸组和非黄疸组,每组各36例.随机将两组患者均分为丙泊酚A、B组和七氟烷A、B组,每组各18例.记录各组患者的苏醒时间、苏醒时BIS、拔管时间及术后不良反应的发生率.结果 七氟烷A组患者苏醒时间和苏醒时BIS、拔管时间最长,丙泊酚A组患者苏醒时间和苏醒时BIS、拔管时间均短于七氟烷A组,差异有统计学意义(P＜ 0.05);丙泊酚B组患者苏醒时间和苏醒时BIS、拔管时间长于七氟烷B组,差异有统计学意义(P＜0.05).丙泊酚B组患者术后24 h术后恶心呕吐、头晕、嗜睡发生率明显低于七氟烷B组,黄疸组患者丙泊酚A组术后24h术后恶心呕吐、头晕、嗜睡发生率明显低于七氟烷A组,差异均有统计学意义(P＜0.05).结论 梗阻性黄疸患者丙泊酚靶控输注麻醉较七氟烷吸入麻醉术后恶心呕吐发生率更低,清醒更迅速,并且丙泊酚的麻醉效果比七氟烷更好.