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目的评价滴定法靶控输注异丙酚镇静在第三磨牙拔除手术中应用的安全性。方法选择择期接受第三磨牙拔除手术的患者60例,年龄19岁~54岁,ASA分级I~II级。随机分为两组:P组(异丙酚组,n=30)和C组(对照组,n=30)。P组:滴定法靶控输注异丙酚,初始血浆浓度0.8μg/ml,每2分钟增加浓度0.2μg/ml。至OAA/S评分3分时,2%利多卡因与1:200000肾上腺素混合液局麻后进行手术。C组:2%利多卡因与1:200000肾上腺素混合液局麻后进行手术。分别观察P组和C组患者术中配合情况,并记录P组患者入室平静后T_0、输注异丙酚起效时(T_1)、局麻时(T_2)、手术开始(T_3)、术中(T_4)、手术结束时(T_5)以及出室时(T_6)的心率、血压、血氧饱和度和呼吸频率和NI指数和对照组在上述对应时间点的心率、血压、血氧饱和度和呼吸频率。并记录相关反应情况。结果两组患者均能配合完成手术。T1~5时心率、收缩压及舒张压P组明显低于C组(P<0.05);血氧饱和度及呼吸频率两组无明显差异,均在正常范围内。NI指数在T_1~5时与T0比较差异有统计学意义(P<0.05)。结论采用滴定法靶控输注异丙酚镇静用于第三磨牙拔除手术是安全有效的。
Objective To evaluate the safety of target controlled infusion of propofol by titration in the treatment of the third molars. Methods Sixty patients (aged 19-54 years) with ASA grading I to II were enrolled in this study. Randomly divided into two groups: P group (propofol group, n = 30) and C group (control group, n = 30). Group P: titration target-controlled infusion of propofol, the initial plasma concentration of 0.8μg / ml, every 2 minutes to increase the concentration of 0.2μg / ml. To OAA / S score 3 points, 2% lidocaine and 1: 200000 epinephrine mixture of local anesthesia after surgery. Group C: 2% lidocaine and 1: 200000 epinephrine mixed local anesthesia after surgery. The patients in group P and group C were observed intraoperatively, and recorded after the onset of sedation T_0, T_1, T_2, T_3, Heart rate, blood pressure, oxygen saturation, respiratory rate and NI index at the end of operation (T_4), T_5 and T_6, and heart rate, blood pressure, oxygen saturation Respiratory rate. And record the relevant reaction. Results Both groups of patients were able to complete the operation. Heart rate, systolic blood pressure and diastolic blood pressure in group P at T1 ~ 5 were significantly lower than those in group C (P <0.05). There was no significant difference between the two groups in blood oxygen saturation and respiratory rate, all within the normal range. NI index at T_1 ~ 5 and T0 difference was statistically significant (P <0.05). Conclusion It is safe and effective to titrate propofol sedation with titration method for the third molars extraction.