摘要
目的观察靶控输注(TCI)丙泊酚麻醉诱导中,维持脑电双频指数(BIS)为50时,复合咪唑安定对丙泊酚靶浓度及血流动力学的影响。方法40例ASAⅠ或Ⅱ级拟行妇科腹腔镜手术病人,随机均分为丙泊酚(P)组和丙泊酚复合咪唑安定(M)组,记录BIS值降至50时的丙泊酚血浆及效应室靶浓度及病人诱导前、BIS值降至50时(诱导后)及气管插管即刻的HR和MAP。结果当BIS值降至50时,M组丙泊酚的血浆及效应室靶浓度及用量均明显低于P组(P<0.05或P<0.01);两组病人诱导后的MAP均较诱导前明显降低(P<0.01),P组诱导后、气管插管即刻的HR较诱导前明显减慢(P<0.05或P<0.01)且明显慢于M组(P<0.05)。结论以BIS值降至50为指标,TCI丙泊酚诱导时复合咪唑安定可明显降低丙泊酚的血浆及效应室靶浓度;可减轻丙泊酚诱导所致HR减慢,但不能减轻丙泊酚诱导所致血压下降;对插管时血流动力学影响两者相似。
Objective To observe the effects of midazolam on anesthesia induction with propofol TCI. Methods Forty ASA physical status 1 or 2 patients scheduled for laparoscopie gynecologic surgery were randomly divided into two groups with 20 cases each. The patients in group P were induced with propofol TCI and fentanyl and vecuronium. Additional midazolam 0.05 mg/kg was used during anesthesia induction in group M. The plasma and effect-site propofol target concentrations at the time of BIS value 50 were recoved. MAP and HR were reeoved before and after induction and at the time of intubation. Results when BIS value decreased to 50, the plasma and effect-site propofol target concentrations of propofol in group M were significantly lower than those in group P（P〈0.01）. MAP after induction in two groups was significantly lower than that before（P〈0. 01）. HR in group P was lower after induction than that before（P〈0.01） and lower than that in group M（P〈0. 05） ; HR of postintubation of P group was significantly slower than preinduction（P〈0. 05） . Conclusion Keeping the BIS at 50, propofol TCI combined with midazolam can significantly lower the plasma and effecvsite propofol target concentrations and avoid propofol-induced slowdown of HR, but can not decrease propofol-induced hypotention.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2009年第7期573-575,共3页
Journal of Clinical Anesthesiology
关键词
丙泊酚
咪唑安定
靶控输注
脑电双频指数
Propofol
Midazolam
Target-controlled infusion
Bispeetral index
