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| 体脂率及体重指数与丙泊酚麻醉用量的相关性 |
| Correlation between body fat percentage and body mass index with the propofol dosage |
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| DOI：10.12089/jca.2018.08.005 |
| 中文关键词: 体脂率 体重指数 闭环靶控输注 丙泊酚 |
| 英文关键词: Body fat percentage Body mass index Closed loop target controlled infusion Propofol |
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| 中文摘要: |
目的 观察患者体脂率及BMI对丙泊酚麻醉用量的影响,并得出丙泊酚麻醉用量简便的计算公式。
方法 选择我院择期行腹腔镜手术患者104例,男46例，女58例，年龄25～59岁,ASA Ⅰ或Ⅱ级,根据BMI和体脂率将患者分为四组：A组，BMI<25.0 kg/m2,体脂率<25%（男）或<35%（女）；B组，BMI<25.0 kg/m2,体脂率≥25%（男）或≥35%（女）；C组，BMI≥25.0 kg/m2，体脂率<25%（男）或<35%（女）；D组，BMI≥25.0 kg/m2，体脂率≥25%（男）或≥35%（女）。所有患者均采用统一的麻醉方案,BIS闭环靶控目标值设为45～55。记录患者麻醉诱导、麻醉维持时丙泊酚使用量以及拔管时间。纳入所有患者的性别、BMI和体脂率等构建多元线性回归模型。
结果 D组丙泊酚麻醉诱导剂量明显高于A、B、C组(P<0.05);B组和D组的前1 h和前2 h每公斤体重丙泊酚用量均明显低于A组(P<0.05),A组和C组的每公斤体重丙泊酚用量差异无统计学意义,B组和D组的每公斤体重丙泊酚用量差异无统计学意义;四组拔管时间差异无统计学意义。回归公式:前1 h丙泊酚用量(mg/kg)=7.715+1.900×性别(男=0,女=1)-0.125×体脂率。
结论 BMI或体脂率越高的患者在维持麻醉状态时每公斤体重丙泊酚使用量越少;当BMI与体脂率衡量肥胖发生矛盾时,体脂率与患者每公斤体重丙泊酚麻醉用量相关性更好。 |
| 英文摘要: |
Objective To investigate the effect of body fat percentage and BMI on the propofol infusion amount in patients, and to obtain a simple formula for the dosage of propofol.
Methods A total of 104 patients, 46 males and 58 females, aged 25 - 59 years, ASA physical status Ⅰ or Ⅱ, undergoing elective laparoscopic surgery were enrolled. The patients were divided into 4 groups: group A, BMI < 25.0 kg/m2 and body fat percentage < 25%(male) or < 35% (female); group B, BMI < 25.0 kg/m2 and high body fat percentage ≥ 25% (male) or ≥ 35% (female), group C, BMI ≥ 25.0 kg/m2 and body fat percentage; < 25% (male) or < 35% (female); and group D, BMI ≥ 25.0 kg/m2 and body fat percentage ≥ 25% (male) or ≥ 35% (female). All patients were treated with a unified anesthesia program, and the bispectral index was controlled at 45-55. The anesthesia-induction propofol dosage, anesthesia-maintenance propofol dosage and extubation time were recorded. All the gender, BMI and body fat percentage were used to construct multiple linear regression models.
Results The anesthesia-induction propofol dosage of group D was higher than those of groups A, B, C (P < 0.05). The anesthesia-maintenance propofol dosage in the first 1 and 2 hours of groups B and D were lower than that in group A (P < 0.05), the dosage of propofol in group A and group C had no significant difference, also the dosage of propofol in group B and group D was not significantly different; the four groups had no significant difference in extubation time. The regression formula was as follows: one hour propofol dosage (mg/kg)=7.715+1.900×gender (male=0, female=1)-0.125×body fat percentage.
Conclusion The patients with higher BMI or body fat percentage use lower dosages of propofol during anesthesia-maintenance. When measuring obesity, the body fat percentage has a better correlation with the propofol dosage than BMI in patients. |
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