2024 年第 4 期 第 19 卷

不同剂量环泊酚对三叉神经痛老年患者全身麻醉诱导期血流动力学及心率变异性的影响

Effects of different doses of ciprofol on hemodynamics and heart rate variability in elderly patients with trigeminal neuralgia during induction of general anesthesia

作者：张焕焕何金华张梦张彧刘妹女李建立

英文作者：Zhang Huanhuan He Jinhua Zhang Meng Zhang Yu Liu Meinyu Li Jianli

单位：河北省人民医院麻醉科，石家庄050051

英文单位：Department of Anesthesiology Hebei General Hospital Shijiazhuang 050051 China

关键词：环泊酚；三叉神经痛；心率变异性；全身麻醉诱导

英文关键词：Ciprofol;Trigeminalneuralgia;Heartratevariability;Generalanesthesiainduction

• 摘要：

• 目的 观察不同剂量环泊酚对三叉神经痛老年患者全身麻醉诱导期血流动力学及心率变异性的影响。方法 选择2022年2—12月于河北省人民医院择期行经皮三叉神经半月节球囊压迫术的三叉神经痛老年患者90例，按照随机数字表法、双盲分为低剂量组（L组）、中剂量组（M组）和高剂量组(H组)，每组30例。L组、M组和H组分别在麻醉诱导时静脉注射环泊酚0.2、0.3和0.4 mg/kg。分别于麻醉诱导前（T0）、气管插管前（T1）、气管插管后（T2）记录心率、平均动脉压（MAP）及脑电双频指数（BIS），并采集短时心率变异性频域参数：低频功率（LF）、高频功率（HF）和低频/高频比值（LF/HFratio）；同时记录不良事件发生情况。结果 与T0时比较，T1时3组、T2时M组和H组患者的心率、MAP及BIS均明显降低（均P＜0.05）；与T1时比较，T2时L组患者的心率及MAP均明显升高（均P＜0.05）。T1、T2时，H组患者的心率、MAP及BIS均明显低于L组和M组（均P＜0.05），T2时，L组患者的心率、MAP显著高于M组（均P＜0.05）。与T0时比较，T1时3组、T2时M组和H组患者的LF、HF及LF/HFratio均明显降低（均P＜0.05）；与T1时比较，T2时L组患者的LF及LF/HFratio均明显升高（均P＜0.05）。T1、T2时，H组患者的LF、HF及LF/HFratio均明显低于L组和M组（均P＜0.05），T2时，L组患者的LF和LF/HFratio显著高于M组（均P＜0.05）。H组不良事件发生率明显高于L组和M组［36.7%（11/30）比10.0%（3/30）、3.3%（1/30）］（χ2=169.25，P＜0.01）。结论 环泊酚用于三叉神经痛老年患者的麻醉诱导，可以维持血流动力学稳定和自主神经功能平衡，与0.2 mg/kg和0.4 mg/kg的诱导剂量相比，0.3 mg/kg的诱导剂量能更安全地应用于三叉神经痛老年患者。

• Objective To observe the effects of different doses of ciprofol on hemodynamics and heart rate variability in elderly patients with trigeminal neuralgia during induction of general anesthesia. Methods Totally 90 elderly patients with trigeminal neuralgia undergoing percutaneous balloon compression in Hebei General Hospital from February to December 2022 were enrolled. They were divided into low-dose group (group L), medium-dose group (group M) and high-dose group (group H) according to the random number table method and double blind, with 30 cases in each group. Patients in group L, group M and group H were injected ciprofol 0.2, 0.3 and 0.4 mg/kg intravenously during anesthesia induction,respectively. Heart rate (HR), mean arterial pressure (MAP) and bispectral index (BIS) were recorded before anesthesia induction (T0), before tracheal intubation (T1) and after tracheal intubation (T2). Short-time heart rate variability parameters in frequency domain were collected, including low frequency power (LF), high frequency power (HF) and LF/HFratio. And the occurrence of adverse reactions was recorded at the same time. Results Compared with T0, HR, MAP and BIS were significantly decreased in three groups at T1, and in the group M and group H at T2 (all P＜0.05). Compared with T1, HR and MAP in group L were significantly increased at T2 (all P＜0.05). At T1 and T2, HR, MAP and BIS in group H were significantly lower than those in group L and group M (all P＜0.05); at T2, HR and MAP in group L were significantly higher than those in group M (all P＜0.05). Compared with T0, LF, HF and LF/HFratio were significantly decreased in three groups at T1 and in group M and group H at T2 (all P＜0.05). Compared with T1, LF and LF/HFratio in group L were significantly higher at T2 (both P＜0.05). At T1 and T2, LF, HF and LF/HFratio in group H were significantly lower than those in group L and group M(all P＜0.05).At T2, LF and LF/HFratio in group L were significantly higher than those in group M (all P＜0.05). The incidence of adverse reactions in group H was significantly higher than that in group L and group M［36.7%(11/30) vs 10.0%(3/30), 3.3%(1/30)］(χ2=169.25，P＜0.01). Conclusions Ciprofol is used for anesthesia induction in elderly patients with trigeminal neuralgia, which can maintain hemodynamic stability and balance of autonomic nervous function. Compared with induction doses of 0.2 mg/kg and 0.4 mg/kg, induction dose of 0.3 mg/kg can be more safely applied to elderly patients with trigeminal neuralgia.