硫喷妥钠和丙泊酚对全身麻醉下剖宫产术中血流动力学、意识及新生儿影响的比较

Comparison of the Effects of Thiopental Sodium and Propofol on Haemodynamics, Awareness and Newborns During Caesarean Section Under General Anaesthesia.

作者信息

Çakırtekin Vedat, Yıldırım Ahmet, Bakan Nurten, Çelebi Nevin, Bozkurt Özkan

机构信息

Clinic of Anaesthesiology and Reanimation, Prof. Dr. Celal Ertuğ Etimesgut State Hospital, Ankara, Turkey.

Clinic of Anaesthesiology and Reanimation, Ümraniye Training and Research Hospital, İstanbul, Turkey.

出版信息

Turk J Anaesthesiol Reanim. 2015 Apr;43(2):106-12. doi: 10.5152/TJAR.2014.75547. Epub 2015 Feb 5.

DOI:10.5152/TJAR.2014.75547

PMID:27366476

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4917150/

Abstract

OBJECTIVE

To compare the effects of propofol and thiopental on haemodynamics, awareness and newborns in pregnant women undergoing elective caesarean section.

METHODS

Seventy pregnant women were assigned into two equal groups. For anaesthesia induction, 2 mg kg(-1) propofol (Group P) and 5 mg kg(-1) thiopental (Group T) were administered. Maternal haemodynamic parameters and bispectral index (BIS) values were recorded before induction, in 1-minute intervals within the first 10 minutes after induction and in 5-minute intervals thereafter, during skin incision, uterine incision, removal of infant, uterine sutures, skin sutures, eye opening and extubation in all cases. Cord blood gas analysis and 1- and 5-minute APGAR scores were recorded. In all cases, a keyword was spelled to ear during removal of the infant, and at the first postoperative hour, patients were questioned. Important time periods of surgery and anaesthesia and also the first postoperative hour haemodynamic values, pain scores, nausea and vomiting were noted.

RESULTS

The demographic data were similar among cases. In Group T, systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and mean arterial pressure (MAP) at the first 2 minutes after induction and heart rate (HR) at almost all time points were significantly higher. BIS values from induction to the eighth minute and skin incision, uterine incision and removal of the infant were lower in Group P. No patient remembered the keyword spelled, while 4 patients reported dreaming during general anaesthesia. The effects of propofol and thiopental sodium on 1- and 5-minute APGAR scores, cord blood gas values and postoperative visual analogue scale (VAS) scores were similar.

CONCLUSION

Propofol is a more appropriate anaesthetic agent than thiopental in anaesthesia for caesareans, since it provides better anaesthestic depth and more rapid recovery.

摘要

目的

比较丙泊酚和硫喷妥钠对择期剖宫产孕妇血流动力学、意识及新生儿的影响。

方法

70例孕妇被分为两组，每组人数相等。麻醉诱导时，丙泊酚组（P组）给予2mg·kg⁻¹丙泊酚，硫喷妥钠组（T组）给予5mg·kg⁻¹硫喷妥钠。记录所有病例诱导前、诱导后最初10分钟内每隔1分钟及此后每隔5分钟的产妇血流动力学参数和脑电双频指数（BIS）值，包括皮肤切开、子宫切开、胎儿娩出、子宫缝合、皮肤缝合、睁眼和拔管时。记录脐血气分析及1分钟和5分钟阿氏评分。所有病例在胎儿娩出时向其耳边拼读一个关键词，术后第1小时对患者进行询问。记录手术和麻醉的重要时间段以及术后第1小时的血流动力学值、疼痛评分、恶心和呕吐情况。

结果

两组病例的人口统计学数据相似。T组诱导后最初2分钟的收缩压（SAP）、舒张压（DAP）和平均动脉压（MAP）以及几乎所有时间点的心率（HR）均显著更高。P组从诱导至第8分钟以及皮肤切开、子宫切开和胎儿娩出时的BIS值较低。没有患者记得拼读的关键词，而4例患者报告在全身麻醉期间做梦。丙泊酚和硫喷妥钠对1分钟和5分钟阿氏评分、脐血气值及术后视觉模拟评分（VAS）的影响相似。