中国临床药学杂志2024，Vol.33Issue(12)：918-922,5.DOI:10.19577/j.1007-4406.2024.12.007
丙泊酚联合不同剂量阿芬太尼对妇科腹腔镜手术患者视神经鞘直径的影响
Effect of propofol combined with different doses of alfentanil on the optic nerve sheath diameter in gynecological laparoscopic surgery
向文青 1孙曼云 1杨柳 1贾菁菁1
作者信息
- 1. 红河州滇南中心医院-昆明医科大学第五附属医院麻醉科,红河 661000
- 折叠
摘要
Abstract
AIM To compare the effect of propofol combined with different doses of target-controlled alfentanil infusion on the optic nerve sheath diameter(ONSD)during gynecological laparoscopic surgery.METHODS A total of 135 patients who underwent gynecological laparoscopic surgery in our hospital from October 2020 to October 2023 were selected as the study subjects,and were divided into low-dose group(infusion of alfentanil 5.0 μg·kg-1),medium-dose group(infusion of alfentanil 7.5 μg·kg-1)and high-dose group(infusion of alfentanil 10.0 μg·kg-1)by a random number table method,with 45 patients in each group.Comparative analyses were conducted on the general data among the 3 groups and the binocular ONSD measurements at various time points:before anesthesia induction(T0),5 min post endotracheal intubation in the supine position(T1),and at 10,30,and 60 minutes following the initiation of CO2 pneumoperitoneum with the head-low foot-high position(T2 to T4),as well as 5 minutes after the closure of CO2 pneumoperitoneum and the return to the supine position(T5).The correlation between alfentanil dose and ONSD was analyzed by multivariate Logistic regression,and a generalized estimating equation(GEE)model of patient intraoperative ONSD at different doses of alfentanil was established.The intraoperative and postoperative adverse reactions among the 3 groups were compared.RESULTS Compared with the low-dose and medium-dose groups,the high-dose group had lower ONSD at T2 and T3(F=1.964,P=0.046;F=2.318,P=0.022).Logistic regression analysis showed a significant correlation between the dose of alfentanyl and ONSD(P＜0.001).The GEE model demonstrated that the high-dose group experienced better improvement in the elevation of intraoperative ONSD than the low-dose and medium-dose groups.The incidence of adverse drug reactions in the high-dose group,at 6.7％,was not significantly different from that in the medium and low-dose groups(P＞0.05).CONCLUSION Propofol combined with high-dose alfentanil target-controlled infusion could effectively slow down the increase of ONSD in patients undergoing gynecological laparoscopic surgery.关键词
丙泊酚/阿芬太尼/腹腔镜手术/视神经鞘直径Key words
propofol/alfentanil/laparoscopic surgery/optic nerve sheath diameter引用本文复制引用
向文青,孙曼云,杨柳,贾菁菁..丙泊酚联合不同剂量阿芬太尼对妇科腹腔镜手术患者视神经鞘直径的影响[J].中国临床药学杂志,2024,33(12):918-922,5.
