Objective:To investigate the optimal plasma target-controlled infusion concentration of propofol for patients under-going painless hysteroscopy. Methods: A total of 90 patients undergoing painless hysteroscopy were randomly divided into three groups (Group LP,Group MP and Group GP),in which propofol target-controlled plasma concentration were set at 4. 0,4. 5 and 5.0 ug/mL,respectively. With bispectral index (BIS) monitoring,the total dosage of propofol,the time patients spent falling into unconsciousness during induction,the changes of hemodynamics and the recovery time were recorded and analyzed. Results: Compared with before induction,mean arterial pressure and heart rate at the time of dilating cervix in Group LP increased significantly (P<0. 05),while they decreased significantly in Group GP (P<0. 05),but they had no significant change in Group MP(P>0. 05). Pulse oxygen saturation in Group LP and Group MP showed no significant change (P>0. 05) but it decreased significantly in Group GP (P<0. 05). BIS value in all three groups decreased at the time of dilating cervix,particularly in Group GP (P<0. 05). The time to fall into unconsciousness in Group MP and Group GP was shorter than that in Group LP (P<0. 05),particularly in Group GP (P<0. 05). Awake time in Group LP and Group MP was shorter than that in Group GP(P<0. 05). There were significantly more cases who had body movement in Group LP than in the other two groups (P<0. 05). Case number of respiratory depression in Group GP was significantly more than those in the other two groups (P <0. 05). There were no significant differences in propofol dosage and operation duration among the three groups (P>0. 05). Conclusion: 4. 5 ug/mL may be the suitable concentration for plasma target-controlled infusion of propofol in painless hysteroscopy.%目的:分析宫腔镜手术静脉麻醉时不同异丙酚血浆靶控浓度的临床效应,以寻找宫腔镜手术中比较合适的异丙酚靶控血浆浓度.方法:选择静脉麻醉下行宫腔镜手术的患者90例,随机分成3组.静脉注射芬太尼1 μg/kg后,异丙酚血浆靶控浓度设为低剂量4.0 μg/mL组(LP组)、中等剂量4.5 μg/mL组(MP组)和高剂量5.0 μg/mL组(GP组).持续监测脑电双频指数(bispectral index,BIS),分析3组患者的异丙酚用量、意识丧失时间以及呼吸循环的变化和术毕清醒时间.结果:与注药前相比,LP组扩宫颈时平均动脉压和心率显著升高(P＜0.05),MP组无显著变化(P＞0.05),GP组显著降低(P＜0.05)；LP组和MP组脉搏氧饱和度无显著变化(P＞0.05),GP组显著下降(P＜0.05)；3组BIS值在扩宫颈时出现了不同程度的下降,其中GP组最低(P＜0.05).MP组和GP组意识丧失时间短于LP组(P＜0.05),GP组意识丧失时间短于MP组(P＜0.05).LP组和MP组清醒时间短于GP组(P＜0.05).LP组出现体动反应的例数显著多于其他2组(P＜0.05)；GP组呼吸抑制的例数显著多于其他2组(P＜0.05).3组患者的异丙酚用量以及手术时间均无显著差异(P＞0.05).结论:异丙酚血浆浓度4.5 μg/mL可能是宫腔镜手术静脉麻醉较适宜的输注浓度.
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