丙泊酚诱导麻醉对腹腔镜胆囊切除术后呕吐的影响.pdf

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1、1396陕西医学杂志2013年1O月第42卷第10期丙泊酚诱导麻醉对腹腔镜胆囊切除术后呕吐的影响解放军第451医院麻醉科(西安710054)张玉良胡俊凯丁冬尹尧摘要目的：观察腹腔镜胆囊切除术(LC)术后呕吐的特点及丙泊酚诱导麻醉对该手术术后呕吐的影响。方法：LC325例，ASAI～Ⅱ级。按诱导用静脉麻醉药的不同分为3组，A组114例，丙泊酚2mg／kg诱导；B组107例，依托咪酯0．4mg／kg诱导；C组104例，2．5硫喷妥钠5mg／kg诱导。其他诱导药物相同，包括：阿托品0．5mg，芬太尼5fg／kg，维库溴铵0

2、．07～o．1mg／kg。诱导后均持续吸入0．5％0～1．5异氟醚维持麻醉；间隔30～40min酌情追加首次维库溴铵用量的1／3～／2。术后48h内双盲法观察呕吐情况。结果：3组病人术后呕吐总发生率分别为47．4、56．1、45．2(P>0．05)。不同时间段呕吐发生情况：丙泊酚组以术后6h以内发生率最低，硫喷妥钠组次之，并显著少于依托咪酯组(P<0．01)；6～12h丙泊酚组最高，硫喷妥钠组次之(均为尸<0．01，组内不同时间段比较)，但该时间段3组间无差异(P>0．05)。依托咪酯组术后24h内相对均衡。结论：L

3、C后呕吐发生率较高，丙泊酚在术后早期抗呕吐作用明显。主题词胆囊切除术，腹腔镜呕吐二异丙酚【中图分类号】R614．2【文献标识码】A【文章编号110007377(2013)10—139603EffectsofpropofolonpostoperativevomitingoflaparoscopycholecystectomyDepartmentofAnesthesia，No．451MilitaryHospital(Xi’an710054)ZhangYuliangHuJunkaiDingdongetalABSTRACTO

4、bjective：Tostudythecharacteristicofpostoperativevomitingoflaparoscopycholecystectomyandtheeffectsofpropofolonthepostoperativevomiting．Methods：325ASAIorlIpatientsunderwentLCprocedureweredividedintothreegroupsinaccordancewiththedifferenceofintravenousanesthetic：g

5、roupA(一114)inducedbypropofolindosageof2mg／kg：groupB(”一107)inducedbyetomidateindosageof0．4mg／kg：groupC(n：104)inducedbythiopentalindosageof5mg／kg．Otherdrugsinducedweresamenessinthreegroups，includingatropine0．5mg，fentanyl5ug／kgandvecuronium0．07～0．1mg／kg．Themainten

6、anceofanesthesiawasperformedbyinhaling0．5～1．5％isofluranecontinullyandinjectingvecuroniumindosageof1／3to1／2inducingdoseat30to40minutesafterinduction．Informationofvomitingwasdoubleblindobtainedwithin48hoursafteroperation．Results：Thevomitingrateofthreegroupswere47

7、．4，56．1and45．2respectively(P>0．05)．ThegroupAhadthefewestvomitingcasesduringpostoperative6hours(P<0．01)．ButthegroupAhadthemostcasesduringthesectionoftimefrom6hourstol2hoursinallfivesectionsoftime(P<0．01)．ThegroupCwassecond(P<0．01)．Threegroupswerenotdifferenteach

8、otherduringthissectionoftime(P>O．05)．ThevomitingcasesofgroupBwasrelativelyequilibriaduringpostoperative24hours．Conclusion：Thevomitingrateafterlaparoscopycholecystectomyisrel