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全静脉麻醉和丙泊酚输注综合征中的生化标志物:一项初步研究。

Biochemical markers in total intravenous anesthesia and propofol infusion syndrome: a preliminary study.

机构信息

Department of Anesthesiology, School of Medicine, Pamukkale University, Denizli, Turkey.

出版信息

Eur Rev Med Pharmacol Sci. 2013 Dec;17(24):3385-90.

Abstract

OBJECTIVES

To investigate biochemically whether total intravenous anesthesia (TIVA) using propofol creates a risk for Propofol Infusion Syndrome (PRIS).

PATIENTS AND METHODS

Forty patients scheduled for thyroid gland surgery were randomly assigned into Group T or C and premedicated 30 min before operation. Group T received remifentanyl hydrochloride, propofol infusion following anesthesia induction with propofol, vecuronium bromide and intubation. Group C received remifentanyl hydrochloride infusion, 1-1.5 MAC desflurane inhalation following anesthesia induction with thiopental, vecuronium bromide and intubation. Patients were respired 50% O2-air mixture. Blood gas, potassium, lactic acid, CK-MB, myoglobin, troponin I, total carnitine, triglyceride, creatinine concentrations were determined before operation, at intraoperative hour-2, postoperative hour-6.

RESULTS

There were no significant differences between groups in potassium, lactic acid CK-MB, myoglobin, total carnitine or creatinine levels. Triglyceride level at intraoperative hour-2 increased in Group T, decreased at postoperative hour-6. Troponin I was higher in Group C than Group T at intraoperative hour-2 (p < 0.05). No asystole, bradycardia, arrhythmia, hypotension or change in urine color was detected.

CONCLUSIONS

The present biochemical findings suggest that TIVA using propofol is safe.

摘要

目的

研究全凭静脉麻醉(TIVA)使用丙泊酚是否会增加丙泊酚输注综合征(PRIS)的风险。

患者和方法

40 名计划行甲状腺手术的患者被随机分为 T 组或 C 组,并在手术前 30 分钟进行预给药。T 组在麻醉诱导时给予丙泊酚、瑞芬太尼盐酸盐、维库溴铵和插管,随后给予丙泊酚输注。C 组在麻醉诱导时给予硫喷妥钠、瑞芬太尼盐酸盐、维库溴铵和插管,随后给予 1-1.5 MAC 地氟烷吸入。患者均以 50%氧气-空气混合物呼吸。在术前、术中第 2 小时、术后第 6 小时测定血气、钾、乳酸、肌酸激酶同工酶(CK-MB)、肌红蛋白、肌钙蛋白 I、总肉碱、甘油三酯、肌酐浓度。

结果

两组间钾、乳酸、CK-MB、肌红蛋白、总肉碱或肌酐水平无显著差异。T 组术中第 2 小时甘油三酯水平升高,术后第 6 小时降低。C 组术中第 2 小时肌钙蛋白 I 高于 T 组(p<0.05)。未发生心动过缓、心律失常、低血压或尿液颜色改变。

结论

目前的生化结果表明,TIVA 使用丙泊酚是安全的。

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