摘要
目的 观察艾司氯胺酮复合丙泊酚在肝癌微波治疗术中的麻醉效果。方法 选择解放军第九七〇医院择期拟行超声引导下微波治疗肝癌患者80例,采用随机数字法分为试验组(艾司氯胺酮组)患者40例(男性26例,女性14例),年龄58.8±10.4岁;对照组(舒芬太尼组)患者40例(男性28例,女性12例),年龄57.9±9.2岁。麻醉开始所有患者静脉注射丙泊酚1.5~2.5 mg/kg至睫毛反射消失,之后观察静脉注射艾司氯胺酮0.5 mg/kg,对照组静脉注射舒芬太尼0.15μg/kg,麻醉维持2组均泵注丙泊酚2 mg·kg^(-1)·h^(-1)。微波治疗过程中,观察患者反应追加丙泊酚0.5~1 mg/kg。观察并记录麻醉开始前(T0)、睫毛反射消失时(T1)、微波治疗开始时(T2)、微波治疗结束时(T3)各时间点的心率、平均动脉压(MAP)。记录2组手术时间,苏醒时间(停药后至呼之睁眼时间),术中丙泊酚用量、呼吸状况及术后不良反应情况。使用SPSS 20.0统计软件进行统计分析。结果 2组患者T0,T1时点比较血流动力学差异无统计学意义(P>0.05);T2时,试验组MAP较对照组升高,差异有统计学意义(P<0.05)。2组患者手术时间比较差异无统计学意义(P>0.05);试验组丙泊酚用量及术中呼吸抑制情况少于对照组,差异有统计学意义(P<0.05)。2组术后不良反应比较无统计学意义(P>0.05)。结论 艾司氯胺酮复合丙泊酚静脉麻醉用于肝癌微波治疗术,可提供良好的镇静镇痛作用,减少丙泊酚用量,减少术中低血压的发生,并且呼吸抑制的发生率降低。
Objective To evaluate the efect of esketamine combined with propofol anesthesia in the percutaneous microwave coagulation therapy(PMCT)for hepatocellular carcinoma(HCC).Methods A total of 80 HCC patients undergoing PMCT from 970th Hospital of the PLA were randomly divided experimental group(esketamine group,n=40)and control group(sufentanil group,n=40):All patients were injected with propofol 1.5~2.5 mg/kg intravenously until their eyelash reflex disappeared,then esketamine 0.5 mg/kg IV in experimental group or sufentanil o.15μg/kg IV in control group.The anesthesia was maintained with propofol 2 mg·kg^(-1)·h^(-1) in both groups which was adjusted by the response of the patients.Hemodynamic changes such as heart rate(HR)and mean arterial pressure(MAP)were observed before anesthesia induction(T0),the time of eyelash reflex disappeared(T1),at the beginning of PMCT(T2)and at the end of PMCT(T3).The operation time,awakening time,the total consumption of propofol and respiratory status during operation and postoperative adverse reactions were recorded in both groups.Statistical analysis was performed with the spss 20.0 statistical software.Results There were no significant hemodynamic diferences between two groups at T0 and Ti(P>0.05).At T2,MAP of experimental group was significantly higher than that of control group(P<0.05).There were no significant differences in operation time time between two groups(P>0.05)..The total consumption of propofol and the time of respiratory depression during operation in experimental group were significantly less than those in control group(P<0.05).There was no significant difference in the incidence of adverse reactions of postoperative between two groups(P>0.05).Conclusion Esketamine combined with propofol anesthesia could provide a safe sedative and analgesic effect in PMCT for HCC,reduce occurrence of hypotension and the incidence of respiratory depression during the operation.
作者
潘志豪
鞠衍馨
刘志武
Pan Zhihao;Ju Yanxin;Liu Zhiwu(Department of Anesthesiology,970th Hospital of the PLA,Yantai 264100,China)
出处
《山西医药杂志》
CAS
2023年第24期1868-1871,共4页
Shanxi Medical Journal
关键词
丙泊酚
肝肿瘤
艾司氯胺酮
微波治疗术
Propofol
Percutaneous microwave coagulation therapy
Esketamine
Hepatocellular carcinoma
