| 苏明萍,杨小霖,敬世霞,邓姣,袁玉红.丙泊酚闭环靶控输注麻醉有效控制腋窝途径-机器人辅助甲状腺手术所致应激反应的麻醉深度探讨[J].中国临床保健杂志,2023,26(6):799-802. |
| 丙泊酚闭环靶控输注麻醉有效控制腋窝途径-机器人辅助甲状腺手术所致应激反应的麻醉深度探讨 |
| Exploring the optimal anesthesia depth for the effective control of stress response induced by BABA-RAT during propofol closed-loop targeted infusion anesthesia |
| 投稿时间：2023-08-22 |
| DOI：10.3969/J.issn.1672-6790.2023.06.019 |
| 中文关键词: 甲状腺切除术 机器人手术 麻醉和镇痛 应激,生理学 二异丙酚 |
| 英文关键词: Thyroidectomy Robotic surgical procedures Anesthesia and analgesia Stress,physiological Propofol 〖FL |
| 基金项目:四川省南充市社会科学研究“十三五”规划项目(NC2020B205) |
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| 中文摘要: |
| 目的 探讨丙泊酚闭环靶控输注麻醉有效控制双侧乳晕和腋窝途径-机器人辅助甲状腺手术(BABA-RAT)所致应激反应的麻醉深度。方法 选取南充市中心医院于2021年1月至2022年6月收治的64例BABA-RAT患者为研究对象,以丙泊酚闭环靶控输注目标脑电双频指数(BIS)值为分组依据,分为对照组(32例)与观察组(32例),对照组BIS为55±5,观察组BIS为45±5(不含50),比较2组丙泊酚用量、血流动力学指标、血清炎症因子水平、镇静效果及风险事件发生率。结果 观察组维持阶段的丙泊酚持续输注量明显高于对照组,差异有统计学意义(P＜0.05)；2组诱导前(T0)、手术1 h(T1)、术毕即刻(T2)、术后6 h(T3)的心率(HR)、平均动脉压(MAP)变化,差异无统计学意义(P＞0.05)；观察组T3、术后24 h(T4)的血清白细胞介素-6、C反应蛋白水平明显低于对照组,差异有统计学意义(P＜0.05)；观察组苏醒时间长于对照组,术后24 h疼痛视觉模拟评分法评分低于对照组,差异有统计学意义(P＜0.05)；2组风险事件发生率比较,差异无统计学意义(P＞0.05)。结论 在BABA-RAT中,应用丙泊酚闭环靶控输注方式将BIS值控制在45±5水平可更加有效地抑制手术应激反应。 |
| 英文摘要: |
| Objective To explore the optimal anesthesia depth for controlling the stress response caused by bilateral areola and axillary pathway robot assisted thyroidectomy (BABA-RAT) with propofol closed-loop target controlled infusion anesthesia.Methods A total of 64 BABA-RAT patients admitted to Nanchong Central Hospital from January 2021 to June 2022 were selected as the study subjects.The target EEG bispectral index (BIS) value of propofol closed-loop target controlled infusion was used as the grouping basis,and they were divided into a control group (n=32) and an observation group (n=32).The BIS of the control group was 55±5,while the BIS of the observation group was 45±5 (excluding 50).The dosage of propofol,hemodynamic indicators,and serum inflammatory factor levels were compared between the two groups Sedative effect and incidence of risk events.Results The sustained infusion of propofol during the maintenance phase in the observation group was significantly higher than that in the control group,with a statistically significant difference (P<0.05);The changes in heart rate (HR) and mean arterial pressure (MAP) before induction (T0),1 hour after surgery (T1),immediately after surgery (T2),and 6 hours after surgery (T3) between the two groups were not statistically significant (P>0.05);The serum levels of interleukin-6 (IL-6) and C-reactive protein (CRP) in the observation group T3 and 24 hours after surgery (T4) were significantly lower than those in the control group,with statistical significance (P<0.05);The awakening time of the observation group was longer than that of the control group,and the visual analog scale (VAS) score 24 hours after surgery was lower than that of the control group,with a statistically significant difference (P<0.05).There was no statistically significant difference in the incidence of risk events between the two groups (P>0.05).Conclusions In BABA-RAT,the use of propofol closed-loop target controlled infusion to control the anesthesia depth BIS value at a level of 45±5 can more effectively suppress surgical stress response. |
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