對放置動脈導管之癌症病人施行Propofol靜脈麻醉

PROPOFOL INTRAVENOUS ANESTHESIA FOR INTRA-ARTERIAL CATHETERIZATION IN CANCER PATIENTS

周笑華(Siu-Wah Chau) ； 吳淑敏(Seok-Mun Ng) ； 曾清楷(Chin-Kai Tseng)

《Acta Anaesthesiologica Sinica》 28卷1期 (1990/03) Pp. 55-61

摘要

對30例需放置動脈導管做化學治療之癌症病人施行Propofol靜脈麻醉。病人術前半小時肌肉內注射Pethidine 1 mg/kg，Atropine 0.007 mg/kg和Prochlorperazine 5 mg做麻醉前給葯。麻醉過程中，病人自然呼吸室內空氣，若SaO_2少於90％，且持續1分鐘時，經面罩給予氧氣。麻醉誘導，經靜脈內注射Propofol 2.0 mg/kg麻醉維持，基本上以Syringe pump持續注入Propofol 12 mg/kg/h，視麻醉深淺隨時調節注入速度結果如下：（一）所有病人都能以Propofol 2.0mg/kg麻醉誘導成功，誘導時間為29.60±5.50秒。麻醉維持雨量平均需12.13±0.43 mg/kg/h。（二）麻醉2分鐘時，心臟血管系統明顯被抑制，收縮壓、舒張壓和心搏出量均比麻醉前降低，分別下降15.78±810％，14.89±10.11％和12.88±3.21％；心搏數稍增2.81±1.64％。（三）PaO_2、SaO_2和pH，在注射麻醉藥2分鐘後，降至最低點，依順序分別降至77.57±658 torr、90.16±4.53％和737±0.02; PaCO_2則升至38.50±5.35 torr。（四）恢復期除1例短暫性的興奮不安外，沒有其他併發症。由停止注入Propofol至病人眼睛張開之時間為9.20±1.79分，會說出自己名字及出生日期之時間為10.73±1.87分。

關鍵字

Propoflo ； Anesthesia for cancer patient patient

並列摘要

Thirty cancer patients scheduled for intra-arterial catheterization for chemotherapy were premedicated with pethidine 1 mg/kg atropine 0.007 mg/kg and prochlorperazine 5 mg intra-muscularly. Anesthesia was induced with 2 mg/kg propofol and maintained with continuous infusion of propofol at a rate of 12 mg/kg/h. Patients breathed room-air spontaneously through the whole course of anesthesia. Anesthesia was induced with 2 mg/kg propofol in all patients, then maintained successfully by using a mean infusion rate of 12.13±0.43 mg/kg/h propofol. They lost con sciousness with in 29.60±5.50 second. Two minutes after induction, there were significantly decreased in systolic pressure, diastolic pressure, stroke volume and cardiac output but heart rate did not change significantly. Blood pressure and cardiac output remained stab le but lower than pre-anesthetic values during the rest of the anesthetic course. Arterial blood gas analysis confirmed the respiratory depression. Two minutes after induction, there were significantly decreased in PaO_2 , SaO_2 and pH were noted . PaCO_2 was increased significantly. Recovery from the anestesia was repid and uneventful. The average time required for the patients to sustain eye-pening and to answer questions were 9.20± 1.79 min and 10.73±1.87 min respectively after discontinuing propofol injection. Transient restlessness occurred in one patient. No other post-operative complications were noted.