摘要
目的分析听觉诱发电位指数(AAI)及脑电双频谱指数(BIS)与芬太尼复合异丙酚镇静深度的相关性。方法拟在全麻下行腹部手术病人45例,年龄40～55岁,随机分为3组(n=15):异丙酚组(P组)、芬太尼2μg／kg复合异丙酚组(FP2组)以及芬太尼5μg／kg复合异丙酚组(FP5组)。P组、:FP2组、FP5组分别静脉注射生理盐水5 ml、芬太尼2、5μg／kg麻醉诱导。4 min后以血浆靶浓度(Cp)1.0μg／ml TCI异丙酚,以后每3分钟递增0．2μg／ml,直至警觉／清醒评分(OAA/S评分)达到1分。分别于病人人室平卧10 min(基础值)、注射芬太尼后4 min、每次调整异丙酚Cp前即刻记录AAI、BIS、平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)、Cp、效应室浓度(Ce),并进行OAA/S评分,对AAI及BIS与OAA／S评分间进行等级相关分析。结果P组、FP2组、FP5组AAI及BIS与OAA／S评分间均呈正相关,三组间BIS与OAA／S评分间相关程度逐渐降低(P<0．05),而组间AAI与OAA／S评分间相关程度比较差异无统计学意义。在病人对呼唤反应消失时,随着芬太尼剂量的增加,BIS逐渐升高,而AAI差异无统计学意义。结论AAI可以监测芬太尼复合异丙酚的镇静深度,而BIS则不能。
Objective To analyze the correlation of auditory evoked potential index （AAI） and bispectral index （BIS） with the depth of sedation induced by fentanyl and propofol. Methods Forty-five ASA I or Ⅱ adult patients undergoing elective abdominal surgery under general anesthesia were included in this study. The patients were randomly divided into 3 groups （ n = 15 each） ： Ⅰ propofol group （P group） ; Ⅱ propofol ＋ fentanyl 2 μg·kg^-1 group （PF2 group） and m propofol ＋ fentanyl 5 μg·kg^-1 （PF5 group）. Baseline AAI, BIS, MAP, HR and SpO2 were measured and recorded before induction of anesthesia. Normal saline 5 ml/fentanyl 2 μg·kg^-1 or 5μg·kg^-1 in 5 ml was injected IV over 30-60 seconds. 4 min later propofol was given by TCI system. The initial target plasma concentration was set at 1.0 μg·ml^-1 and was increased by 0.2μg·ml^-1 every 3 min until OAA/S score reached 1 （5 = alert, 1 = does not respond to prodding）. The expected plasma concentration （Cp） and the effectsite concentration （Ce） of propofol, AAI and BIS values were monitored and recorded for different OAMS scores and their correlation with the sedation induced by propofol-fentanyl was analyzed. Whether the interaction between fentanyl and propofol could be reflected by BIS or AAI was analyzed too：Results During induction of anesthesia with propofol and fentanyl, the AAI and BIS values were decreasing as the sedation was deepening and were correlated significantly with the OAA/S scores. When the patients did not respond to verbal command （OAA/S score = 2）, the BIS values were significantly different among the 3 groups but there was no significant difference in AAI values among the 3 groups. Conclusion AAI can reflect the depth of sedation induced by propofol and fentanyl but BIS can not.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2006年第10期926-928,共3页
Chinese Journal of Anesthesiology
关键词
诱发电位
听觉
脑电描记术
芬太尼
二异丙酚
清醒镇静
Evoked potentials, auditory
Electroencephalogram
Fentanyl
Propofol
Conscious sedstion
