Suppr
超能文献

靶控输注丙泊酚和七氟醚维持麻醉对肾移植血流动力学影响的比较

Comparison of the Effects of Target-Controlled Infusion of Propofol and Sevoflurane as Maintenance of Anesthesia on Hemodynamic Profile in Kidney Transplantation.

作者信息

Aditianingsih Dita, Sukmono Besthadi, Agung Tjues A, Kartolo Willy Y, Adiwongso Erika S, Mochtar Chaidir A

机构信息

Department of Anesthesiology and Intensive Care, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo General Hospital, Diponegoro Street No. 71, DKI Jakarta 10430, Indonesia.

Department of Urology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo General Hospital, Diponegoro Street No. 71, DKI Jakarta 10430, Indonesia.

出版信息

Anesthesiol Res Pract. 2019 Nov 29;2019:5629371. doi: 10.1155/2019/5629371. eCollection 2019.

DOI:10.1155/2019/5629371

PMID:31885551

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6925739/

Abstract

BACKGROUND

Target-controlled infusion (TCI) propofol and sevoflurane are common agents for general anesthesia, including for kidney transplantation procedure. This study compared the effect of TCI propofol and sevoflurane on intraoperative hemodynamic profile in kidney transplant patients.

METHODS

A single-blinded prospective study was performed in 46 kidney transplant recipients who were randomized into receiving TCI propofol or sevoflurane as anesthetics maintenance. Hemodynamic parameters such as mean arterial pressure (MAP), cardiac index (CI), stroke volume index (SVI), and systemic vascular resistance index (SVRI) were measured at baseline before induction, postintubation, first surgical incision, every 15 minutes after the first incision, reperfusion, and 15 minutes after reperfusion. Data were analyzed using unpaired -test, paired -test, and general linear model.

RESULTS

Intraoperative MAP, CI, SVI, and SVRI changes were similar in both groups ( = 0.480, 0.216, 0.086, and 0.054). In comparison to the baseline value, TCI propofol and sevoflurane groups showed significant reductions of MAP at postintubation (=0.010; < 0.001) and during the first surgical incision (=0.009; < 0.001); significant reduction of CI at postintubation (=0.003; < 0.001) and during the first surgical incision ( < 0.001; < 0.001); significant reduction of SVI at postintubation (=0.013; =0.008), during the first surgical incision (=0.008; =0.003), and 15 minutes after reperfusion (=0.010; =0.005); and significant increasing of SVRI during the first surgical incision (=0.007; =0.005). The TCI propofol group showed significantly lower SVRI compared to the sevoflurane group postintubation (=0.029) and during the first surgical incision (=0.026).

CONCLUSION

Intraoperative hemodynamic profile was similar between the TCI propofol and sevoflurane group during kidney transplant surgery. The TCI propofol group had higher CI and SVI but showed significantly lower SVRI as compared to the sevoflurane group. The incidence of postanesthesia agitation, postoperative outcome, and complication were not significantly different between the two groups.

摘要

背景

靶控输注丙泊酚和七氟醚是全身麻醉常用药物，包括用于肾移植手术。本研究比较了靶控输注丙泊酚和七氟醚对肾移植患者术中血流动力学的影响。

方法

对46例肾移植受者进行单盲前瞻性研究，将其随机分为接受靶控输注丙泊酚或七氟醚作为麻醉维持用药。在诱导前基线、插管后、首次手术切口时、首次切口后每15分钟、再灌注时以及再灌注后15分钟测量平均动脉压（MAP）、心脏指数（CI）、每搏量指数（SVI）和全身血管阻力指数（SVRI）等血流动力学参数。采用非配对t检验、配对t检验和一般线性模型进行数据分析。

结果

两组术中MAP、CI、SVI和SVRI变化相似（P分别为0.480、0.216、0.086和0.054）。与基线值相比，靶控输注丙泊酚组和七氟醚组在插管后（P = 0.010；P < 0.001）和首次手术切口时（P = 0.009；P < 0.001）MAP显著降低；插管后（P = 0.003；P < 0.001）和首次手术切口时（P < 0.001；P < 0.001）CI显著降低；插管后（P = 0.013；P = 0.008）、首次手术切口时（P = 0.008；P = 0.003）和再灌注后15分钟（P = 0.010；P = 0.005）SVI显著降低；首次手术切口时（P = 0.007；P = 0.005）SVRI显著升高。靶控输注丙泊酚组在插管后（P = 0.029）和首次手术切口时（P = 0.026）的SVRI显著低于七氟醚组。