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1、不同时间注射丙泊酚对全麻病人气管拔管反应及麻醉苏醒的影响【摘要】目的：探讨不同时间注射丙泊酚对全麻病人气管拔管反应及麻醉苏醒的影响。方法：20～60岁病人120例行腹部手术，ASA分级Ⅰ～Ⅱ级，无肝肾及内分泌系统疾病,随机分为4组，每组30例。Ⅰ组：对照组,满足拔管指征即拔管;Ⅱ组：满足拔管指征,丙泊酚用药后1min拔管;Ⅲ组：满足拔管指征,丙泊酚用药后5min拔管;Ⅳ组：满足拔管指征,丙泊酚用药后10min拔管;监测麻醉诱导前、术毕丙泊酚注射前、拔管时、拔管后5min时心率、血氧饱和度、血压，
2、记录各组拔除气管至清醒对答的时间等情况。结果：气管拔管时Ⅱ组和Ⅲ组心血管反应、躁动明显低于Ⅰ组(P<0.05)，Ⅱ组清醒时间、低血氧饱和度明显高于Ⅰ组(P<0.05)，Ⅳ组心血管反应、清醒时间、躁动、清醒时间、低血氧饱和度较Ⅰ组差异无统计学意义(P>0.05)。结论：全麻病人术毕有拔管指征，立即注射丙泊酚1mg/kg，用药后5min行气管拔管是安全、有效的。【关键词】丙泊酚;剂量;拔管反应;苏醒延迟 AbstractObjective:ToinvestigateEffecto
3、fInjectingPropofolatDifferenttimesonExtubationResponseandAnesthesiaWakeupinPatientsSubjecttoGeneralAnesthtization.Methods:Aseriesof120patients,ranginginagefrom20to60,7receivedabdominalsurgery.ASAgradingwasI～II.Nodiseasewasdetectedintheliver,kidneyand
4、endocrinesystemineachpatient.Theyweredividedatrandominto4groups,eachincluding30cases.GroupIwasthecontrolgroupinwhichextubationwasconductedastheymettheextubationindications.InGroupII,IIIandIV,extubationwasconductedwhentheymettheextubationindications1,
5、5and10minutesafteradministrationofpropofol,respectively.Heartrate(HR),oxygensaturation(SpO2)andmeanarterialpressure(MAP)weremonitoredbeforetheinductionofanesthesia,aftertheoperation,beforeinjectingpropofol,atthetimeofextubationand5minutesafterextubat
6、ion.Thestatusofthepatientsfromthetimeofextubationtosoberanswerwastakendown.Results:Onextubation,cardiovascularresponseandrestlessweredramaticallylowerinGroupI(P<0.05).SobertimeandSpO2ingroupIIweresignificantlyhigherthanthoseinGroupI(P<0.05).The
7、rewasnoremarkabledifferenceincardiovascularresponse,sobertime,restlessandlowSpO2betweenGroupIIandGroupI(P>0.05).Conclusion:Inthepatientsreceivinggeneralanesthesia,extubationshouldbeperformed5minutesafterimmediateinjectionofpropofolatadoseof1mg/kgw
8、hentheyshowedextubationindications.7 KeywordsPropofol;Dosage;Extubationresponse;Delayedrecovery 全麻病人术毕气管拔管引起的不良反应是一个值得重视的问题,气管拔管期可发生明显的血压升高、心率增快、呼吸急促及躁动等情况。预防或减少拔管期的不良反应，对保证病人(尤其是高龄及有心脑血管系统疾病的病人)的围手术期安全、舒适和顺利康复十分重要。有研究提出在一定麻醉深度下拔管，侧重药物对拔管反应的影响，往往忽视
