应用胸电生物阻抗法观察丙泊酚静脉麻醉对血流动力学的影响

目的:应用无创电生物阻抗法(TEB)评价丙泊酚静脉麻醉对行人工流产术的育龄妇女血流动力学的影响,探讨单纯丙泊酚对近似于正常人的心功能的影响.方法:50例接受人工流产手术的患者,用丙泊酚静脉麻醉,诱导剂量为2～2.2 mg/kg,用质量分数为2%的丙泊酚,在20 s的时间内均匀注入,术中病人有略微肢动时追加30～50 mg丙泊酚以维持麻醉深度.记录麻醉前(T1)、麻醉后(T2)、追加丙泊酚(T3)、手术结束(T4)、唤醒(T5)5个时间点的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)、心排量(CO)、每搏量(SV)、体血管阻力(SVR)及心室收缩加速度指数(ACI).将T1、T2、T3、T4、T5时间点所测得的结果与T1时间点所测得的结果进行比较.结果:T2与T1比较SBP、DBP、MAP、HR、CO、SV、ACI均降低且有显著性差异(P＜0.01),SVR升高(P＜0.01);T3与T1比较SBP、DBP、MAP、HR均降低且有显著性差异(P＜0.05),CO、SV、ACI降低(P＜0.01),SVR升高(P＜0.01);T4与T1比较HR、CO、SV、ACI有显著性差异(P＜0.01),T5与T1比较,HR、CO、SV、ACI降低有显著性差异(P＜0.01),SBP降低(P＜0.05),SVR升高(P＜0.01).患者术后恢复迅速而完全,无明显不良反应.结论:丙泊酚静脉麻醉对育龄妇女行人工流产手术期间的心肌收缩力有抑制作用、外周血管阻力增加,间接说明丙泊酚有心功能抑制作用.应用无创电声物阻抗法监测血流动力学指标,具有操作简便,可重复性好、可及时应用而不受条件限制的特点.

Effects of propofol intravenous anaesthesia on hemodynamics in women undergoing induced abortion by applicating thoracic electrical bioimpedance

Aim:To observe effects of propofol intravenous anaesthesia on Hemodynamics in women undergoing induced abortion by applications thoracic electrical bioimpedance(TEB). Methods: 50 female patients undergoing induced abortion,received propofol intravenous anaesthesia,induction dose was 2 mg~2.2 mg/kg,superaddition propofol 30 mg~50 mg to maintain anaesthesia depth.Hemodynamics were measured at time before induction(T1),after induction(T2),maintain propofol(T3),end operation(T4),arouse(T5).Results: Significant decrease in SBP,DBP,MAP,HR,CO,SV,ACI were observed at T2 compared with the value of T1.Significant increase in SVR at T2 compared with the value of T1.Significant decrease in SBP,DBP,MAP,HR,CO,SV,ACI were observed at T3 compared with the value of T1.Significant increase in SVR at T3 compared with the value of T1.Significant decrease in SBP,DBP,MAP,HR,CO,SV,ACI were observed at T4 compared with the value of T1.Significant increase in SVR at T4 compared with the value of T1.Patients recovered rapidly and completely without side effects.Conclusion:Propofol intravenous anaesthesia can depress myocardial contractivity and increases the total peripheral resistance in women undergoing induced abortion.