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1、第24卷第5期西安交通大学学报(医学版)Vol.24No.52003年10月JournalofXipanJiaotongUniversity(MedicalSciences)Oct.2003硬膜外麻醉下持续靶控输注丙泊酚的镇静效果王国恩,雷晓鸣,薛荣亮(西安交通大学第二医院麻醉科,陕西西安 710004)摘要:目的 评价丙泊酚靶控输注(TCI)在硬膜外阻滞麻醉不同镇静分级时的脑电双频谱指数(BIS)与生命体征变化。方法 择期硬膜外麻醉下行中下腹部手术的53例患者,采用自身对照,比较在不同Ramsay分级时,丙泊酚靶控-1输注的效应部位浓度(ESC)与BIS值生命体征变化。结果
2、在Ramsay4级时的ESC为(1.66±0.16)mg·L,BIS为78.5±4.6,生命体征平稳,其HR、MAP、RRS、SPO2与Ramsay2级比较无差异(P>0.05);与Ramsay5级、6级比较差异有显著性(P<0.01)。结论 随着丙泊酚靶控输注的效应部位浓度的增加,BIS值呈计量相关性下降并能指导镇静分级。在硬膜外阻滞麻醉下Ramsay镇静4级时较为适宜,生命体征平稳,并发症少。关键词:丙泊酚;靶控输注;脑电双频谱指数;镇静;硬膜外麻醉中图分类号:R971文献标识码:A文章编号:167128259(2003)0520513202Thesedativeeffec
3、tofpropofolontargetcontrolledinfusionduringepiduralanesthesiaWangGuoen,LeiXiaoming,XueRongliang(DepartmentofAnesthesiology,SecondHospitalofXipanJiaotongUniversity,Xipan710004,China)ABSTRACT:ObjectiveToevaluatethebispectral(BIS)indexofdifferentsedationstagesandvitalsignsduringsedationproduced
4、bypropofolwithtarget2controlledinfusionunderepiduralanesthesia.MethodsFifty2threepatientsscheduledforelectivemedianandbelowabdomensurgeryunderepiduralanesthesiawererecruitedinthestudy.ThepatientsweresedatedwithpropofolgivenbyTCI,BP,HR,SPO2.Bispectralindicesweremonitoredandrecordedsimultaneou
5、slyandcorrelatedwithRamsaydegree,comparedwiththeeffectivesiteconcentration(ESC)ofpropofolgivenbyTCI,andtherelationshipofBISandvitalsigns.ResultsAtthe4thRamsaydegree,-1ESCandBISwere(1.6±0.16)mg·Land78.50±4.60,respectively,andvitalsignswerestable.HR,MAP,andSPO2weresignificantlydifferentfromtho
6、seat5th,6thRamsaydegrees(P<0.01),buttheywerenotdifferentfromthoseat2thRamsaydegree(P>0.05).ConclusionThereisgoodcorrelationbetweenBISandESCofpropofolgivenbyTCI,andBIScanpredictthelevelofsedation.The4thRamsaydegreeisapplicableunderepiduralanesthesiaandvitalsignsarestableandcomplicationsarefew
7、.KEYWORDS:propofol;target2controlledinfusion;sedation;bispectralindex;epiduralanesthesia 硬膜外阻滞复合静脉麻醉可以增强麻醉效果。丙ASA1-2级、择期硬膜外麻醉下行中下腹部手术的泊酚靶控输注(targetcontrolledinfusion,TCI)与脑电双患者53例,男25例,女28例;年龄23～60岁,体重频谱指数(bispectralindex,BIS)是一种全新的静脉麻50～72kg。其中普外
