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比较三种不同追加剂量丙泊酚输注对择期手术全身麻醉期间插管条件和血流动力学变化的影响:一项随机、安慰剂对照、双盲临床试验。

Comparing the effects of three different additional doses of propofol infusion on intubation condition and hemodynamic changes during general anesthesia under elective surgery: A randomized, placebo-controlled, double blind clinical trial.

作者信息

Safavi Mohammadreza, Honarmand Azim, Banisadr Golnaz

机构信息

Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Adv Biomed Res. 2014 May 28;3:122. doi: 10.4103/2277-9175.133195. eCollection 2014.

Abstract

BACKGROUND

Laryngoscopy and endotracheal intubation can induce unfavorable hemodynamic changes as propofol itself can induce hypotension. The aim of this study was to compare the effects of three different additional doses of propofol infusion on intubation conditions and hemodynamic changes occurred after intubation.

MATERIALS AND METHODS

This double-blinded prospective study was performed on 140 patients aged 18-60 who received different additional doses of propofol and were randomly allocated into 4 groups as follows: A: Received additional dose of propofol 0.5 mg/kg infused after an initial dose 1.5 mg/kg. B: Received additional dose of propofol 1 mg/kg infused after an initial dose 1 mg/kg. C: Received additional dose of propofol 1.5 mg/kg after an initial dose 1 mg/kg. D: Received propofol 2 mg/kg as a bolus with no additional dose.

RESULTS

Intubation conditions were acceptable in 91.4% of Group A patients, 94.2% of Group B patients, 97.1% of Group C patients and 68.5% of Group D patients. There were no significant differences in the mean of heart rate between four groups at any time before and after laryngoscopy. Mean arterial pressure (MAP) 3 min after laryngoscopy was significantly lower in Group D versus Group A (P = 0.015) while MAP was not different at any time between other groups.

CONCLUSION

Infusion of propofol 1.5 mg/kg added to initial bolus dose of propofol 1 mg/kg improves intubation conditions significantly without inducing hemodynamic changes.

摘要

背景

喉镜检查和气管插管可诱发不良血流动力学变化,因为丙泊酚本身可导致低血压。本研究的目的是比较三种不同追加剂量的丙泊酚输注对插管条件及插管后发生的血流动力学变化的影响。

材料与方法

本双盲前瞻性研究纳入了140例年龄在18至60岁之间的患者,这些患者接受了不同追加剂量的丙泊酚,并被随机分为4组,如下:A组:在初始剂量1.5mg/kg后追加丙泊酚剂量0.5mg/kg输注。B组:在初始剂量1mg/kg后追加丙泊酚剂量1mg/kg输注。C组:在初始剂量1mg/kg后追加丙泊酚剂量1.5mg/kg。D组:静脉推注丙泊酚2mg/kg,无追加剂量。

结果

A组91.4%的患者、B组94.2%的患者、C组97.1%的患者和D组68.5%的患者插管条件可接受。喉镜检查前后任何时间,四组患者的心率平均值均无显著差异。喉镜检查后3分钟,D组的平均动脉压(MAP)显著低于A组(P = 0.015),而其他组之间在任何时间MAP均无差异。

结论

在丙泊酚初始推注剂量1mg/kg的基础上追加输注1.5mg/kg丙泊酚可显著改善插管条件,且不会诱发血流动力学变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b887/4063089/ad0780f91741/ABR-3-122-g001.jpg

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