摘要
目的研究麻醉深度指数(CSI)在休克患者围手术期麻醉深度的监测和调控作用,力争做到精确麻醉。方法应用前瞻性研究,将2015年1月~2018年1月收治的70例休克患者随机分为两组,对照组由同一组医师根据临床经验调节麻醉用药,观察组以CSI监测值反馈调节诱导期、维持期药物剂量,CSI维持在(50±5)。结果插管后5min(T1)时刻观察组MAP高于对照组,手术结束(T2)时刻HR低于对照组,而MAP高于对照组(P<0.05);T1、T2时刻观察组CSI高于对照组(P<0.05);观察组中入室后不用镇静药完成诱导插管例数多于对照组,观察组瑞芬太尼、丙泊酚的维持用量低于对照组,苏醒时间短于对照组,死亡率低于对照组,术毕48h内可拔管率高于对照组(P<0.05)。结论在休克患者围手术期,CSI监测和调控可避免麻醉过深,减少麻醉药物用量,有助于减少生命体征的波动范围,有利于患者抢救复苏,提高抢救成功率,降低死亡率,可行性强。
Objective To study the monitoring and regulating effect of CSI on perioperative anesthetic depth in patients with shock,and strive to achieve accurate anesthesia. Methods In the prospective study,70 patients with shock from January 2015 to January 2018 were randomly divided into two groups.The control group was controlled by the same group of physicians according to clinical experience.The observation group adjusted the induction period with the CSI monitoring value and maintained the drug dosage,CSI was maintained at（50±5）. Results At 5 min after intubation（T1）,MAP in the observation group was higher than that in the control group,HR was lower than that in the control group at the end of operation（T2）,and MAP was higher than that in the control group（P 0.05）.The CSI of the observation group was higher than that of the control group at T1 and T2（P 0.05）.There were more cases of intubation without sedation in the observation group than in the control group.The maintenance dosage of remifentanil and propofol in the observation group was lower than that in the control group,the recovery time was shorter than that in the control group,and the mortality was lower than that in the control group.The rate of extubation in 48 hours after operation was higher than that in control group（P 0.05）. Conclusion Monitoring and control of CSI during perioperative period of shock patients can avoid excessive anesthesia,reduce the dosage of anesthetic drugs, help to reduce the fluctuating range of vital signs,help patients to rescue and resuscitate,improve the success rate of rescue,and reduce the mortality rate.
作者
蔡剑波
廖梅苑
李悄媛
陈长江
陈潮世
马华斌
CAI Jianbo;LIAO Meiyuan;LI Qiaoyuan;CHEN Changjiang;CHEN Chaoshi MA Huabin(The Sixth People＇s Hospital of Huizhou City,Huizhou 516211,China)
出处
《中国医药科学》
2018年第8期97-99,136,共4页
China Medicine And Pharmacy
基金
广东省惠州市科技计划项目(20150802)
关键词
休克
围手术期
麻醉深度指数
监测
调控
Perioperative period
Anesthesia depth Index
Monitoring
Regulation
