摘要
目的 比较反馈靶控输注(TCI)和病人自控镇静(PCS)在硬膜外麻醉下择期手术病人 中的应用。方法 选择50例ASAⅠ～Ⅱ级、年龄18～70岁的妇科择期手术病人,随机分成T组 (TCI)和P组(PCS),每组25例。硬膜外穿刺成功后,使麻醉平面维持在T6以下,同时连接TCI系 统和PCS系统并设置参数。切皮前5min开始系统给药,手术结束前5min停止给药,持续观察脑电 双频指数(BIS)、频谱边界频率(SEF)、高频(HF)、低频(LF)的变化,并评定镇静深度(OAA/S评分 法)。术毕记录丙泊酚的总用量及按压次数、苏醒时间和手术医师的满意度评分。结果 P组丙泊 酚用量明显少于T组(P<0.01),而各时间点MAP、BIS、SEF、HF、LF、LF/HF、HRV的变化无显著 性差异(P>0.05),两组病人及手术医师的满意度一致(P>0.05)。结论 PCS和反馈TCI是两种 安全有效的镇静方法。
Objective To compare the clinical effect of feedback target-controlled infusion (TCI) and patient-controlled sedution (PCS) of propofol for sedation in patients undergoing surgeries under epidural anesthesia. Methods Fifty ASAⅠ-Ⅱ patients aged 18-70 years, scheduled for gynecological surgery under epidural anesthesia were randomly allocated to one of two groups: group T and group P. The analgetic plane was lower than T 6. The TCI or PCS pump was connected and parameters were set respectively. The changes of the bispectral index (BIS),95% spectral edge frequency (SEF),low frequency (LF),high frequency (HF), LF/HF,mean arterial pressure (MAP),heart rate variability (HRV) and SpO 2 were recorded at various time points. The total dose of propofol and the frequences of pressing were noted. The surgeon’s assessment and the patient’s response to the technique were enquired separately.Results The dose of propofol in group P was significantly less than that in group T (P<0.01). The patient's and surgeon's satisfaction was not significantly defferent between two groups. So did the number of patients who would prefer PCS or TCI next time. The changes of MAP, HR, BIS, SEF, LF, HF, HRV, SpO 2 didn’t show any statistic differences among the recordings of defferent time points. Conclusion Both feedback target-controlled infusion and patient-controlled sedation with propofol can provide an effective and safe sedation, and are strongly preferred by patients.
出处
《临床麻醉学杂志》
CAS
CSCD
2005年第1期17-19,共3页
Journal of Clinical Anesthesiology
