摘要
目的:研究麻醉深度指数(Cerebral state inder,CSI)反馈调控老年肿瘤患者靶控输注(Target controlled infusion,TCI)丙泊酚的效果。方法:胃癌及直肠癌根治术126例,年龄≥65岁,ASAⅠ～Ⅱ级,随机分为反馈靶控组和靶控组,每组各63例。反馈组设定CSI=50,两组丙泊酚的血浆靶浓度设定为2μg/ml,舒芬太尼的血浆靶浓度麻醉诱导时1.5ng/ml,麻醉维持时0.3ng/ml。记录基础值(T1)、插管(T2)、插管后5min(T3)、切皮(T4)、肿瘤切除(T5)和手术结束(T6)等时点的MAP、HR、HRV和CSI值的变化,统计丙泊酚的用量。结果:靶控组在插管后5min(T3)、切皮(T4)、切肿瘤(T5)等时点的MAP下降比反馈靶控组明显(P<0.05);HRV在插管后5min(T3)、肿瘤切除(T5)时下降较反馈靶控组明显(P<0.05);反馈靶控组的CSI值波动小于靶控组(P<0.05),丙泊酚的用量也小于靶控组(P<0.05)。结论:麻醉深度指数反馈调控靶控输注丙泊酚对老年肿瘤患者的麻醉安全可行。
Objective：To study the clinical benefit of propofol anesthesia with target-controlled influsion technic modulated by cerebral state index in the elderly patients with tumor. Methods：A total of 126 ASA Ⅰ or Ⅱ aged65 yrs or older patients underwent gastrectomy and rectal surgery were randomly divided into tow groups（n=63 each）：group by target-controlled influsion technic modulated（group Ⅰ ）and group by target-controlled influsion（group Ⅱ ）. CSI of group Ⅰ was 50. Propofol of two groups was administered by TCI at a target blood concertration of 2 μ g/ml during induction of anesthesia and maintenance of anesthesia,sufentanil of two groups was administered by TCI at a target blood concertration of 1.5 μg/ml during induction of anesthesia and of 0.3ng/ml during maintenance of anesthesia. MAP,HR,HRV and CSI of the foundation（T1）,intubation（T2）, five minutes after intubation（T3）,chip（T4）,the tumor excision（T5） and the end of surgery（T6） were recorded. And the total of propofol was recorded. Results：MAP at T3,T4 and T5 of group Ⅱ decreased obviously compared to that of group Ⅰ （P〈0.05）; HRV of group Ⅰ at T4 and T5 decreased obviously compared to that of group Ⅰ （P〈0.05）;The undulation with CSI of group Ⅰ was less than that of groupl] （p〈0.05）,the total propofol of groupⅡwas less than that of group Ⅰ （P〈0.05）.Conclusion：Propofol anesthesia with target-controlled influsion technic modulated by cerebral state index in the elderly patients with tumor was safe and applicable.
出处
《重庆医科大学学报》
CAS
CSCD
2008年第6期730-732,共3页
Journal of Chongqing Medical University
关键词
麻醉意识深度指数
靶控输注
丙泊酚
老年肿瘤患者
Cerebral state index
Target controlled infusion
Propofol
The elderly patients with tumor
