摘要
目的 探讨意识指数（index of consciousness,IoC）监测指导无痛人工流产术中丙泊酚用药的可行性.方法 选择自愿行无痛人工流产者100例,年龄20～30岁,ASA Ⅰ或Ⅱ级,采用随机数字表法将患者均分为IoC监测组（IoC组）和临床组（C组）.两组患者均采用TCI丙泊酚复合芬太尼麻醉,丙泊酚血浆靶浓度从4.0μg/ml起始,静脉缓慢注射芬太尼1.0μg/kg.IoC组TCI丙泊酚至IoC指数为40～60之间,将IoC始终维持在45±3,且根据IoC值调整丙泊酚血浆靶浓度;C组采用改良OAA/S评分对患者进行镇静评估,输注丙泊酚至OAA/S评分达到1分（对轻度摇动患者躯体无反应）.记录给药前、睫毛反射消失、扩宫、吸宫和清醒时的MAP、HR、SpO2,记录丙泊酚用量、术后苏醒时间及定向力恢复时间,观察术中不良反应发生情况.结果 与C组比较,IoC组丙泊酚用量减少,苏醒时间及定向力恢复时间明显缩短（P＜0.05）;体动发生率明显降低（P＜0.05）,而两组呼吸抑制、头晕、恶心呕吐发生率差异均无统计学意义.与给药前比较,睫毛反射消失、扩宫、吸宫时两组患者MAP明显降低,HR明显减慢（P＜0.05）,SpO2差异无统计学意义.结论 IoC监测对无痛人工流产术中的丙泊酚用药和麻醉深度调控有很好的指导意义.
Objective To examine the feasibility of using index of consciousness （IoC） for monitoring the sedation depth with propofol in artificial abortion surgery.Methods One hundred ASA Ⅰ or Ⅱ patients aged 20-30 y undergoing artificial abortion surgery were randomly divided into two groups：group IoC and standard clinical group （group C） both received a propofol/fentanyl anesthesia,according to the target plasma concentrations of propofol administered by TCI during induction of anesthesia.The initial plasma propofol concentration was 4.0 μg/ml and fentanyl 1.0 μg/kg was infused slowly.In group C,the modified OAA/S score was used to evaluate the sedation depth and propofol was infused continuously until OAA/S score was one （stands for no respond to prodding）,then the target plasma concentrations of propofol was regulated according to hemodynamics.In group IoC,propofol was infused continuously until IoC drop to 60-40,the target plasma concentrations of propofol was regulated maintaining IoC 45 ± 3.BP,HR,SpO2,the amount of propofol,the recovery time,orientation time and the side effects were recorded.Results Compared with group C,the amount of propofol was smaller,the recovery time and orientation time were shorter and the incidence of body during operation was lower in group 1oC （P＜0.05）.Conclusion Index of consciousness monitoring has guiding significance to control the sedation depth with propofol in artificial abortion surgery.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2014年第3期239-241,共3页
Journal of Clinical Anesthesiology
关键词
意识指数
监测
丙泊酚
人工流产
Index of consciousness
Monitoring
Propofol
Abortion artificial
