摘要
目的 评价脑电双频谱指数 (bispectralindex ,BIS)作为丙泊酚靶控输注的反馈控制变量用于硬膜外麻醉下腹腔镜子宫切除术病人镇静的效果。 方法 6 0例择期在硬膜外麻醉下行腹腔镜子宫切除术的病人 ,随机分为两组 :反馈靶控输注组 (FTCI,n =30 )和靶控输注组 (TCI,n =30 )。丙泊酚的血浆靶控浓度均设定为 2mg/L ,TCI组整个手术期维持不变 ,FTCI组BIS作为控制变量设定在 70。记录并比较两组BIS值、平均动脉压 (MAP)和心率 (HR)的最高值和最低值、丙泊酚的单位标准化剂量、定向力恢复时间、术中的遗忘程度和满意度。 结果 FTCI及TCI组BIS最高值分别为 76 1± 6 4、86 0± 8 6 ,最低值分别为 6 9 0± 4 5、6 0 9± 11 8,组间对比有统计学意义 (t =- 5 0 5 8,- 3 5 13;P =0 0 0 0 ) ;平均动脉压的最高值分别为 ( 90 9±14 2 )、( 10 0 4± 11 6 )mmHg ,最低值分别为 ( 74 2± 12 5 )、( 6 3 8± 13 8)mmHg,组间对比有统计学意义 (t=- 2 838,- 3 0 5 9;P=0 0 0 6 ,0 0 0 3) ;定向力恢复时间分别为 ( 4 40 .8± 14 1 0 )s、( 5 76 4± 12 0 5 )s ,两组也有统计学差异 (t=- 4 0 0 4 ,P =0 0 0 0 ) ;FTCI组丙泊酚总剂量明显低于TCI输注组 [分别为 ( 5 10 4 8± 82 75 )mg与 ( 6 2 0
Objective To evaluate the effectiveness of EEG bispectral index (BIS) as the feedback control variable of target-controlled infusion (TCI) of propofol for sedation in patients undergoing laparoscopic hysterectomy under epidural anesthesia. Methods A total of 60 patients for selective operation of laparoscopic hysterectomy under epidural anesthesia were randomly divided into two groups: the feedback TCI group (FTCI) and the TCI group (TCI),with 30 patients in each group.The target blood concentration of propofol was set up at a level of 2 mg/L.It was maintained unchanged in the TCI group throughout the surgery.The BIS value,as the control variable,was set up at 70 in the FTCI group.The highest and lowest BIS values,mean arterial pressure (MAP) and HR during the operation,the standardized unit dose of propofol,time for orientation recovery,the degree of amnesia during the operation and patient's satisfaction were recorded and compared between the two groups. Results Of the two groups: the maximum of BIS values were 76 1±6 4 and 86 0±8 6,respectively,with statistically significant difference ( t = -5 058, P =0 000),and the minimal values were 69 0±4 5 and 60 9±11 8,respectively,with significant difference ( t =-3 513, P =0 000); the highest MAPs were (90 9±14 2) mm Hg and (100 4±11 6) mm Hg,respectively,with significant difference ( t =-2 838, P =0 006),and the lowest,(74 2±12 5) mm Hg and (63 8±13 8) mm Hg,respectively,with statistical significance ( t =-3 059, P = 0 003); the time for orientation recovery was (440 8±141 0)s and (576 4±120 5)s,respectively,with significant difference ( t = -4 004, P =0 000).Total dose of propofol in the FTCI group [(510 48±82 75)mg] was statistically lower than that in the TCI group [(620 65±76 79)mg; t =-5 345, P =0 000],the same was the standardized unit dose of propofol [FTCI: (5 08±1 26)mg,TCI:(6 02±0 86)mg; t =-3 375, P =0 001].No significant differences were seen between the two groups in the degree of amnesia during the operation and patient's satisfaction. Conclusions BIS is feasible to be used as a feedback control variable in propofol anesthesia.It offers less propofol consumption,appropriate sedation,rapid recovery of orientation and more stable blood pressure.
出处
《中国微创外科杂志》
CSCD
2004年第4期337-338,340,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
丙泊酚
靶控输注
脑电双频谱指数
腹腔镜子宫切除
Propofol
Target-controlled infusion
Bispectral index
Laparoscopic hysterectomy
