摘要
目的探讨老年患者异丙酚分步靶控输注(TCI)时预测效应室浓度(CE)的变化及其相应镇静程度和麻醉深度指数(CSI)变化的关系。方法 20例老年患者,进行异丙酚分步TCI,靶浓度从0.5μg/mL开始递增,递增梯度为0.5μg/mL,每1靶浓度输注5min,直至清醒镇静评分(OAA/S)为0后继续输注5min停止,试验中每间隔20s行OAA/S评分,监测并记录患者平均动脉压(MAP)、心率(HR)及脉搏血氧饱和度(SpO2),预测效应室浓度和CSI值。计算在丧失语言反应及意识消失时的预测效应室浓度的CE05、CE50和CE95以及CSI05、CSI50与CSI95。结果随着异丙酚效应室浓度增加,CSI逐渐降低,CSI与OAA/S评分均有较好的相关性。出现语言反应消失时的CE50与CSI50分别为1.3μg/mL和69.7μg/mL;出现意识消失时的CE50与CSI50分别为1.5μg/mL和64.3μg/mL。结论 CSI与预测效应室浓度、OAA/S呈高度相关性,可以较好地监测老年人异丙酚麻醉的深度。
【Objective】To assess the changes of the effect compartment concentration（CE） and cerebral state index（CSI） during a propofol step-by-step target-controlled infusion（TCI） in the elderly.【Methods】In 20 patients aged 67-78 yr during the TCI of propofol,the propofol infusion was set at an initial effect-site concentration of 0.5 μg/mL,and increased by 0.5 μg/mL every 5 min until 5 min after the observer＇s assessment of alertness/sedation scale（OAA/S） values reaching zero.The predicted effect-site concentration of propofol,the values of CSI were recorded,and the sedation level were examined by the OAA/S every 20 s.SBP,DBP,HR,ECG,SpO2 and CSI were monitored.The predicted effect-site concentrations of propofol and the values of CSI at LVC and LOC in 5%,50% and 95% of the patients were calculated.【Results】CSI was positively correlated with OAA/S score,but negatively with Ce.The predicted effect-site concentration of propofol at LVC in 50% of the patients was 1.3μg/mL.The value of CSI at LVC in 50%of the patients was 69.7μg/mL.The predicted effect-site concentration of propofol at LOC in 50%of the patients was 1.5μg/mL.The value of CSI in 50%of the patient was 64.3μg/mL.【Conclusion】 CSI is correlated well with CE and OAA/S.CSI can be used for monitoring the depth of sedation during a step-by-step TCI of propofol in the elderly.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2010年第9期1351-1353,1357,共4页
China Journal of Modern Medicine
关键词
老年人
二异丙酚
靶控输注
麻醉深度指数
cerebra1 state index
propofol
target-controlled infusion
the elderly
