Jain Kavita, Sethi Surendra Kumar, Damor Mamta, Jain Neena
Department of Anaesthesiology, JLN Medical College and Hospital, Ajmer, Rajasthan, India.
Department of Anaesthesiology, RNT Medical College, Udaipur, Rajasthan, India.
Anesth Essays Res. 2017 Jan-Mar;11(1):174-180. doi: 10.4103/0259-1162.183165.
Propofol is a commonly used induction agent during general anesthesia. As a sole agent, it does not provide any strong analgesic effect. The nitrous oxide (NO) used along with propofol for induction of anesthesia augments the induction characteristics and reduces the dose of propofol.
To study the effects of inhaled NO on the induction dose and time of propofol during general anesthesia and also its hemodynamic response and adverse effects.
The present research is a prospective, randomized, double-blind comparative study.
The study population consisted of eighty patients aged 18-60 years from either sex, American Society of Anesthesiologists physical status 1 and 2 which were scheduled for various elective surgical procedures under general anesthesia. The patients were randomly allocated into two groups comprising forty patients in each group. All patients were premedicated with glycopyrrolate 0.2 mg, ondansetron 4 mg, and fentanyl 1 μg/kg intravenously. Group FN received breathing mixture of gases (67% NO @ 4 L/min and 33% O @ 2 L/min), and propofol and Group FO received 100% O @ 6 L/min and propofol. The different hemodynamic parameters (heart rate, mean arterial pressure, systolic blood pressure, diastolic blood pressure, and SpO) were measured.
All observations were analyzed using Chi-square test, Student's -test, and analysis of variance.
The mean induction time and dose were significantly less in Group FN as compared to Group FO ( < 0.05). The mean induction time was 172 ± 32 s in Group FN as compared to 242 ± 43 s in Group FO ( < 001), whereas the mean induction dose was 56.10 ± 13.92 mg in Group FN as compared to 81.67 ± 17.64 mg in Group FO ( < 0.05). The hemodynamic parameters remained stable with no complications.
The coadministration of NO during induction of anesthesia with propofol not only reduced the induction dose of propofol but also reduced induction time significantly. Furthermore, it provided stable hemodynamics without any complications.
丙泊酚是全身麻醉中常用的诱导药物。作为单一药物，它不具有任何强效镇痛作用。与丙泊酚联合用于麻醉诱导的氧化亚氮（NO）可增强诱导特性并减少丙泊酚的剂量。
研究吸入NO对全身麻醉期间丙泊酚的诱导剂量和时间及其血流动力学反应和不良反应的影响。
本研究是一项前瞻性、随机、双盲对照研究。
研究对象为80例年龄在18 - 60岁之间、性别不限、美国麻醉医师协会身体状况分级为1级和2级、计划在全身麻醉下进行各种择期手术的患者。患者被随机分为两组，每组40例。所有患者均静脉注射0.2mg格隆溴铵、4mg昂丹司琼和1μg/kg芬太尼进行术前用药。FN组吸入混合气体（67% NO，4L/min，33% O₂，2L/min）并注射丙泊酚，FO组吸入100% O₂（6L/min）并注射丙泊酚。测量不同的血流动力学参数（心率、平均动脉压、收缩压、舒张压和SpO₂）。
所有观察结果采用卡方检验、t检验和方差分析进行分析。
与FO组相比，FN组的平均诱导时间和剂量显著更低（P < 0.05）。FN组的平均诱导时间为172 ± 32秒，而FO组为242 ± 43秒（P < 0.01）；FN组的平均诱导剂量为56.10 ± 13.92mg，而FO组为81.67 ± 17.64mg（P < 0.05）。血流动力学参数保持稳定，无并发症发生。
在丙泊酚麻醉诱导期间联合使用NO不仅降低了丙泊酚的诱导剂量，还显著缩短了诱导时间。此外，它提供了稳定的血流动力学，且无任何并发症。
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