摘要
目的:观察不同剂量舒芬太尼复合丙泊酚全身麻醉诱导气管插管过程中,以脑电双频指数(bispectral index,BIS)为指标的皮层功能状态以及相应的血流动力学变化,探讨舒芬太尼复合丙泊酚的合理剂量。方法:40例ASAⅠ～Ⅱ级无心、脑疾患的乳腺癌择期手术患者,随机分为4组:Ⅰ组为对照组静注生理盐水,Ⅱ、Ⅲ、Ⅳ组分别接受舒芬太尼0.2μg/kg、0.4μg/kg、0.6μg/kg后,继之以输液泵持续输注丙泊酚使BIS值稳定在45±5,并维持3min后显露声门完成气管内插管。结果:诱导插管后,Ⅰ、Ⅱ组血压、心率较基础值明显改变,Ⅲ、Ⅳ组则变化不明显(P>0.05);插管刺激使Ⅰ、Ⅱ、Ⅲ组BIS值较插管前明显升高,而Ⅳ组BIS值升高却不明显。结论:丙泊酚与0.4μg/kg、0.6μg/kg的舒芬太尼可以有效减弱插管所致的心血管反应,且与0.6μg/kg的舒芬太尼还能抑制插管对皮层状态的激活。
Objective： To observe changes of bispectral index （BIS）and hemodynamic response during anesthetic induction and intubation with different doses of sufentanil and propofol, and determine the optimal doses of the agents. Methods： Forty ASA Ⅰ-Ⅱ patients undergoing elective radical excision for breast cancer were randomly divided into four groups（ten cases each group）： group Ⅰ was injected normal saline as control group; group Ⅱ, Ⅲ and Ⅳ were intravenously administered sufentanil 0.2 μg/kg, 0.4 μg/kg and 0.6 μg/kg respectively.Intratracheal intubation was performed following maintenance of BIS at the level of 45- 5 for 3 min. ECG and cardiovascular variables were recorded at pre-induction, pre-intubation and postchanged compared with pre-intubation （P〈0.05）, but no significant changes in group Ⅲ and group Ⅳ. In group Ⅰ no signifi Ⅱ and Ⅲ BIS was increased to 53.5±4.1, 54.4±3.6 and 49.1±2.8 respectively,while in group Ⅳ, cant increase of BIS was noticed, Conclusion： Sufentanil 0.4 μg/kg, 0.6 μg/kg can effectively blunt the patient＇s hemodynamic response to intubation, but only 0.6 μg/kg sufentanil attenuates the arousal of cerebral activity.
出处
《天津医科大学学报》
2007年第2期213-216,共4页
Journal of Tianjin Medical University
