摘要
目的 比较靶控输注依托咪酯和异丙酚使患者意识消失时的BIS值.方法 择期拟在全凭静脉麻醉下行颈内动脉内膜剥脱术患者120例,年龄18~64岁,ASA分级Ⅰ-Ⅲ级,采用随机数字表法分为6组(n=20):R0e组、R1e组、R2e组和R0p组、R1p组、R2p组. R1e组和R1p组瑞芬太尼效应室靶浓度为1 ng∕ml,R2e组和R2p组瑞芬太尼效应室靶浓度为2 ng∕ml.诱导开始时先靶控输注瑞芬太尼至设定效应室浓度,R0e组、R1e组和R2e组以血浆靶浓度0.6 μg∕ml为起点开始靶控输注依托咪酯,此后每分钟增加依托咪酯的血浆靶浓度0.1 μg∕ml直至患者意识消失;R0p组、R1p组、R2p组以血浆靶浓度2 μg∕ml为起点开始输注异丙酚,其后以每分钟1 μg∕ml的速率增加,直至患者意识消失.记录患者粘贴BIS电极后,靶控输注瑞芬太尼达效应室浓度和患者意识消失时的BIS值.结果 与R0p组比较,R0e组患者意识消失时BIS值降低(P<0. 05);与R1p组比较,R1e组患者意识消失时BIS值降低(P<0. 05);与R2p组比较,R2e组患者意识消失时BIS值低( P<0. 05).结论与异丙酚比较,靶控输注依托咪酯使患者意识消失时的BIS值显著降低.
Objective To compare the bispectral index ( BIS) values at loss of consciousness in-duced by etomidate and propofol given by target-controlled infusion (TCI). Methods A total of 120 Amer-ican Society of Anesthesiologists physical statusⅠ-Ⅲ patients, aged 18-64 yr, scheduled for elective ca-rotid endartrectomy under total intravenous anesthesia, were divided into R0e, R1e, R2e, R0p, R1p and R2p groups (n=20 each) using a random number table method. R1e and R1p groups received remifentanil at an target effect-site concentration (Ce) of 1 ng∕ml, and R2e and R2p groups received remifentanil at an target Ce of 2 ng∕ml. At the beginning of anesthesia induction, remifentanil was given by TCI until the pre-set effect-site concentration was achieved, and etomidate was given by TCI at an initial target plasma con-centration of 0. 6 μg∕ml followed by an increase by 0. 1 μg∕ml every minute until loss of consciousness in R0e, R1e and R2e groups, and propofol was given by TCI at an initial target plasma concentration of 2 μg∕ml followed by an increase by 0. 1 μg∕ml every minute until loss of consciousness in R0p, R1p and R2p groups. BIS values were recorded immediately after pasting the BIS electrode, when the preset Ce of remifentanil was achieved and at loss of consciousness. Results Compared with group R0p, BIS values were significantly decreased at loss of consciousness in group R0e ( P<0. 05) . Compared with group R1p, BIS values were significantly decreased at loss of consciousness in group R1e ( P<0. 05) . BIS values were significantly lower at loss of consciousness in group R2e than in group R2p ( P<0. 05) . Conclusion BIS values are significantly lower at loss of consciousness induced by TCI of etomidate than propofol.
作者
谭彬彬
陈君
余剑波
Tan Binbin;Chen Jun;Yu Jianbo(Nankai Clinic College of Tianjin Medical University Department of Anesthesiology,Tianjin Nankai Hospital,Tianjin 300100,China;Department of Anesthesiology,Tianjin Huanhu Hospital,Tianjin 300060,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2018年第7期843-846,共4页
Chinese Journal of Anesthesiology
