摘要
目的研究听觉诱发电位指数(AAI)复合喉罩技术用于老年患者下腹手术静脉复合全麻的可行性。方法择期行斜疝修补手术的老年患者28例,随机分为两组。Ⅰ组通过维持AAI值于30±5左右来调节异丙酚的靶浓度值。Ⅱ组仅凭临床经验来调节异丙酚的靶浓度值。观察记录诱导前(T0)、诱导后喉罩置入前(T1)、喉罩置入时(T2)、电切镜置入时(T3)、手术进行30 m in时(T4)、术终患者改良镇静清醒评分(OAA/S)≥4分时(T5)6个时间点的心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)和AAI。记录丙泊酚和芬太尼的用量以及麻醉清醒时间,即停用异丙酚至术终患者改良镇静清醒评分(OAA/S)达4分时的时间。结果Ⅰ组平均清醒时间为(8±3)m in,Ⅱ组平均清醒时间为(16±5)m in,两组间比较差异有统计学意义(P<0.05)。Ⅰ组异丙酚的实际用量明显少于对照组,差异有统计学意义(P<0.05)。T3、T4时点Ⅰ组的AAI值明显高于Ⅱ组,差异有统计学意义(P<0.05),Ⅱ组的SBP、DBP、MAP明显较Ⅰ组低。结论AAI通过为麻醉深度监测提供量化指标,可有效应用于喉罩通气时的老年患者短小手术静脉复合麻醉,减少麻醉药物的过量使用。
Objective To study the feasibility of auditory evoked potential index（AAI） modulating the depth of general anesthesia in the elderly with laryngeal mask anesthesia. Methods Twenty - eight ASA physical status of Ⅱ - Ⅲ patients undergoing selective lower abdominal surgery were divided into two groups with 14 cases each. The anesthesia was induced by fentanyl, propofol, and maintained with TCI of propofol. The depth of anesthesia with TCI of propofol was modulated by AAI in group Ⅰ or by hemodynamics in group Ⅱ. HR, SBP, DBP, MAP and AAI were recorded. The time of awakening from anesthesia （the time when OAA/S reached 4 score after the withdrawal of propofol） and the dosage of propofol and fentanyl were recorded. Results The time of awakening from anesthesia was （16 ± 5 ）min in group Ⅱ, which was significantly longer than that in group Ⅰ （P 〈 0. 05 ）. The total dosage of propofol in group Ⅰ was significantly lower than that in group Ⅱ（ P 〈 0. 05 ）. The value of AAI could be used to predict the depth of anesthesia. Conclusion AAI is valuable in assessment of anesthetic depth during general anesthesia with laryngeal mask anesthesia in the elderly.
出处
《临床医学》
CAS
2007年第3期29-31,共3页
Clinical Medicine
关键词
听觉诱发电位
异丙酚
喉罩
全麻
老年
Auditory evoked potential index
Propofol
Laryngeal mask
General anesthesia
The elderly
