摘要
目的探讨靶控输注(TCI)丙泊酚和雷米芬太尼的相互关系及对脑电双频指数(BIS)的影响。方法全身麻醉患者100例,根据丙泊酚不同血浆靶浓度随机均分为五组:P1.5组,1.5μg/ml;P2组,2μg/ml;P2.5组,2.5μg/ml;P3组,3μg/ml;P3.5组,3.5μg/ml。待血浆浓度和效应室浓度达到平衡后TCI雷米芬太尼,以血浆浓度0ng/ml为起点,每30秒增加0.3ng/ml,直至患者意识消失及对疼痛刺激(50Hz,80mA,0.25ms强直刺激)无体动反应。记录患者在不同丙泊酚血药浓度下意识消失时和对疼痛刺激无反应时雷米芬太尼的血浆浓度(Cp)和效应室浓度(EC)。结果意识消失时雷米芬太尼Cp50从P1.5组至P3.5组分别为5.0、3.0、2.1、1.2、0ng/ml;疼痛刺激无反应时雷米芬太尼Cp50从P1.5组至P3.5组分别为5.4、4.3、3.9、3.5、3.0ng/ml;疼痛刺激无反应时与意识消失时BIS值的差异无统计学意义。结论BIS值变化与丙泊酚血药浓度呈反比关系,雷米芬太尼对BIS值影响不大。BIS值50～60可以作为丙泊酚和雷米芬太尼静脉复合麻醉时监测意识消失的良好指标。
Objective To study the relationship of target controlled infusion （TCI） propofol and remifentanil at the time point of loss of consciousness and response to noxious stimulus. Methods One hundred unpremedicated patients were randomly assigned to receiving TCI propofol with constant target concentrations of 1.5, 2, 2.5, 3. 3.5 μg/ml. After blood-effect site equilibration, they were infused remifentanil by a microcomputer controlled pump in Minlo pharmacokinetics model until loss of consciousness and of response to a standard noxious stimulus. Blood and effect-site remifentanil concentrations were predicted. Results The volumes of remifentanil Cp50 at loss of consciousness were 5.0, 3.0. 2.1, 1.2 and 0 ng/ml for groups of P1.5, P2, P2.5, P4 and P3.5, respectively. The volumes of remifentanil Cp50 at loss of response to noxious stimulus were 5.4, 4.3, 3.9, 3.5 and 3.0 ng/ml for groups of P1.5,P2,P2.5,P4 and P3.5,respectively. There was no statistical significance in BIS at the time of loss of consciousness and response to noxious stimulus. Conclusion Bispectral index is a good predictor of sedation monitoring.
出处
《临床麻醉学杂志》
CAS
CSCD
2008年第12期1028-1030,共3页
Journal of Clinical Anesthesiology
关键词
靶控输注
丙泊酚
雷米芬太尼
脑电双频指数
Target controlled infusion
Propofol
Remifentanit
Bispectral index
