文章摘要
丙泊酚与七氟醚对妇科腹腔镜患者视神经鞘直径的影响
Effects of propofol and sevoflurane on optic nerve sheath diameter in patients undergoing gynecological laparoscopic surgery
  
DOI：10.12089/jca.2020.11.004
中文关键词: 腹腔镜  丙泊酚  七氟醚  颅内压
英文关键词: Laparoscope  Propofol  Sevoflurane  Intracranial pressure
基金项目:河南省医学科技攻关计划省部共建备选项目（2018010006）
作者单位E-mail
杨贯宇 450052,郑州大学第一附属医院麻醉与围术期医学部麻醉科  
朱泽飞 450052,郑州大学第一附属医院麻醉与围术期医学部麻醉科  
郑红雨 450052,郑州大学第一附属医院麻醉与围术期医学部麻醉科  
何士凤 450052,郑州大学第一附属医院麻醉与围术期医学部麻醉科  
孙振涛 450052,郑州大学第一附属医院麻醉与围术期医学部麻醉科 gentlesun@126.com 
摘要点击次数: 2725
全文下载次数: 608
中文摘要:
      
目的 应用超声测量视神经鞘直径（ONSD）方法评价丙泊酚与七氟醚对妇科腹腔镜患者颅内压的影响。
方法 选择择期行妇科腹腔镜手术患者40例，年龄20～60岁，BMI 18～27 kg/m2，ASAⅠ或Ⅱ级。采用随机数字表法分为丙泊酚组（P组）和七氟醚组（S组），每组20例。麻醉维持：P组静脉泵注丙泊酚4～12 mg·kg-1·h-1，S组吸入1%～2%七氟醚。使用容量控制模式，VT6～8 ml/kg，FiO2 50%，I∶E 1∶2，RR 12～20次/分。记录麻醉诱导后5 min（T0）、气腹开始后头低脚高位5 min（T1）、气腹开始后头低脚高位30 min（T2）、气腹开始后头低脚高位60 min（T3）时的HR、MAP、气道峰压（Peak）、气道平台压（Plat）、PET CO2 和ONSD。
结果 与T0时比较，T1—T3时P组MAP明显降低，T2—T3时S组MAP明显降低（P＜0.05），T1—T3时两组Peak、Plat明显升高（P＜0.05），T1—T3时两组ONSD明显升高（P＜0.05）。T1时P组MAP明显低于S组（P＜0.05）。T3时P组ONSD明显低于S组（P＜0.05）。
结论 在妇科腹腔镜手术中，与单纯使用七氟醚比较，应用丙泊酚维持可一定程度减轻颅内压的升高。
英文摘要:
      
Ojective To evaluate the effect of propofol and sevoflurane on intracranial pressure in patients undergoing gynecological laparoscopic surgery by ultrasound measurement of optic nerve sheath diameter (ONSD).
Methods Forty patients, aged 20-60 years, BMI 18-27 kg/m2, ASA physical status Ⅰ-Ⅱ, scheduled for elective gynecological endoscopic surgery,were divided into two groups (n = 20) by random number table method：propofol group (group P) and sevoflurane group (group S). Anesthesia maintenance: 4-12 mg·kg-1·h-1 of propofol was injected intravenously in group P, 1%-2% sevoflurane was inhaled in group S. The patients were mechanically ventilated in volume-controlled mode, with VT 6-8 ml/kg, FiO2 50％, I∶E 1∶2 and RR 12-20 times/min. HR, MAP, Peak, Plat, PET CO2 , and ONSD were recorded at the following four time points: 5 min after anesthesia induction (T0), 5 min, 30 min and 60 min of head-down tilt at the beginning of pneumoperitoneum (T1-T3).
Results Compared with T0, MAP in Group P decreased significantly at T1-T3, MAP in group S decreased significantly at T2-T3(P < 0.05), Peak and Plat increased significantly at T1-T3(P < 0.05), and ONSD increased significantly at T1-T3(P < 0.05). MAP in group P was significantly lower than that in group S at T1(P < 0.05). ONSD in Group P was significantly lower than that in group S at T3(P < 0.05).
Conclusion Compared with sevoflurane alone, propofol maintenance can relieve the increase of intracranial pressure in gynecologic laparoscopic surgery.
查看全文   查看/发表评论  下载PDF阅读器
关闭