摘要
目的探讨环泊酚对2型糖尿病(T2DM)患者麻醉诱导期血流动力学的影响。方法选取于2021年6月至2022年11月在山西医科大学第一医院接受全麻手术的60例T2DM患者,随机分为环泊酚组和丙泊酚组。环泊酚组患者依次静脉给予舒芬太尼0.3μg/kg,环泊酚0.3~0.4 mg/kg,顺式阿曲库铵0.15 mg/kg;丙泊酚组给予舒芬太尼0.3μg/kg,丙泊酚1.5~2.0 mg/kg,顺式阿曲库铵0.15 mg/kg完成诱导。记录患者麻醉前(T_(0))、给药后2 min(T_(1))以及气管插管后1 min(T_(2))、3 min(T_(3))、5 min(T_(4))的平均动脉压(MAP)和心率(HR)。于T_(0)、T_(2)、T_(4)取静脉血检测血浆去甲肾上腺素、皮质醇、胰岛素及血糖水平。记录注射痛等不良反应的发生情况。结果两组临床资料比较,MAP组间主效应差异具有统计学意义(F_(组间)=4.354,P=0.041),时点间主效应差异具有统计学意义(F_(时间)=449.057,P<0.001),组间和时点间存在交互作用(F_(交互)=16.246,P<0.001)。两组HR组间主效应差异无统计学意义(F_(组间)=0.210,P=0.649),时点间主效应差异有统计学意义(F_(时间)=129.015,P<0.001),时间点和组间存在交互作用(F_(交互)=8.810,P<0.001)。环泊酚组气管插管后去甲肾上腺素水平较术前上升幅度大于丙泊酚组(F_(交互)=15.638,P<0.001)。诱导插管前后两组皮质醇、胰岛素及血糖水平差异无统计学意义(P>0.05)。环泊酚组低血压(16.7%vs.40%)和注射痛(6.7%vs.36.7%)的发生率明显低于丙泊酚组(P<0.05)。结论与丙泊酚比较,环泊酚应用于T2DM患者全麻诱导,血流动力学波动更平稳,可能与其抑制交感神经系统作用较轻和注射痛发生率较低有关。两者对机体应激反应的影响无显著差异。
Objective To investigate the effects of ciprofol on hemodynamics in type 2 diabetes(T2DM)patients during anesthesia induction.Methods Sixty patients with T2DM scheduled for elective surgery in the First Hospital of Shanxi Medical University from June 2021 to November 2022 were randomly divided into two groups:ciprofol group(n=30)and propofol group(n=30).Patients in ciprofol group received sufentanil 0.3μg/kg,ciprofol 0.3~0.4 mg/kg and cis-atracurium 0.15 mg/kg intravenously.Patients in propofol group received sufentanil 0.3μg/kg,propofol 1.5~2.0 mg/kg and cis-atracurium 0.15 mg/kg intravenously.The changes in mean arterial pressure(MAP)and heart rate(HR)were observed before induction of anesthesia(T_(0)),2 min after administration of ciprofol or propofol(T_(1)),1 min after endotracheal intubation(T_(2)),3 min after intubation(T_(3))and 5 min after intubation(T_(4))in both groups.Blood samples were collected at T_(0),T_(2) and T_(4) to record the changes in norepinephrine,cortisol,glucose and insulin in plasma.Adverse effects such as injection pain were also noted.Results Comparing the clinical data between the two groups:there was an interaction between the time points of MAP and the groups(F Interaction=16.246,P<0.001);the difference in the main effect between the groups(F group=4.354,P=0.041)and among the time points(F time=449.057,P<0.001)was significant.There was an interaction between the time points of HR and the groups(F Interaction=8.810,P<0.001);the difference in the main effect among the time points(F time=129.015,P<0.001)was significant;there was no significant difference in the main results between the groups(F group=0.210,P=0.649).The norepinephrine level after intubation in ciprofol group increased more significantly than that in propofol group(F Interaction=15.638,P<0.001).There was no significant difference in plasma cortisol,blood glucose or insulin concentration between the two groups before or after intubation(P>0.05).The incidences of hypotension(16.7%vs.40%)and injection pain(6.7%vs.36.7%)i
作者
张涵云
吕洁萍
张月灏
张鼎发
Zhang Hanyun;LüJieping;Zhang Yuehao;Zhang Dingfa(College of Anesthesiology,Shanxi Medical University,Taiyuan 030001,China;The First Hospital of Shanxi Medical University,Taiyuan 030012,China)
出处
《实用药物与临床》
CAS
2023年第9期796-801,共6页
Practical Pharmacy and Clinical Remedies
基金
北京康盟慈善基金(S111)。
关键词
2型糖尿病
环泊酚
丙泊酚
血流动力学
应激反应
Type 2 diabetes mellitus
Ciprofol
Propofol
Hemodynamics
Stress response
