异丙酚靶控输注全麻诱导时BIS值与机体应激反应关系的研究.docVIP

异丙酚靶控输注全麻诱导时BIS值与机体应激反应关系的研究 安徽省立医院麻醉科 230001 胡利国 方才( 朱运莲 【摘要】 目的 观察异丙酚靶控输注（TCI）用于全麻诱导时，脑电双频谱指数（BIS）值与应激反应的关系。方法 30例气管插管全麻下手术病人随机分为3组，每组各10例。其中Ⅰ组BIS值维持在36~45，Ⅱ组BIS值维持在46~55，Ⅲ组BIS值维持在56~65范围内，分别于麻醉诱导前（T0）、插管即刻（T1）以及插管后1min（T2）、3min（T3）、5min（T4）和10min（T5）记录HR和MAP，同期抽取桡动脉血，测定血糖和皮质醇。结果 Ⅰ组MAP、HR于T3 、T4时点持续下降（P ( 0.05或P ( 0.01），且T4时点MAP低于Ⅲ组同期水平（P ( 0.05），Ⅱ组T4时点MAP低于基础值（P ( 0.05）。Ⅲ组血糖和皮质醇水平T2、T3时点高于T0（P ( 0.05），血糖T2~ T4时点较Ⅰ组同期水平升高（P ( 0.05），T 3、T4时点较Ⅱ组同期水平升高（P ( 0.05）。Ⅲ组T2、T3时点皮质醇水平明显高于Ⅰ组和Ⅱ组同期水平（P ( 0.05或P ( 0.01）。结论 异丙酚TCI用于全麻诱导时，将BIS值控制在46~55范围，能够减轻机体的应激反应。 【关键词】 全麻；应激反应；气管插管；脑电双频谱指数 A clinical study on the relationship between the bispectral index values and the stress response during anesthesia induction by target-controlled influsion of propofol Hu Liguo, Fang Cai, Zhu Yunlian. Department of anesthesiology, Anhui Provincial Hospital, Hefei 230001 CHINA 【Abstract】 Objective To observe the relationship between the bispectral index (BIS) and the stress response during anesthesia induction by target-controlled influsion (TCI) of propofol. Methods Thirty ASAⅠ~Ⅱ patients (17 males,13 females), aged 25~60yr and body weighting 47~75 kg , scheduled for elective abdominal surgery under general anesthesia were randomly divided into three group with 10 patient in each group. The BIS values in groupⅠwas kept between 36~45, groupⅡ 46~55 and groupⅢ 56~65. HR, MAP, blood glucose and cortisol were respectively recorded before anesthesia induction（T0）, during intubation（T1）, 1min（T2）, 3min（T3）, 5min（T4）and 10min（T5） after intubation. Results The three groups were comparable 基金项目：安徽省卫生厅临床医学重点学科专项基金（编号：2004Z006） 作者单位：230001 合肥市，安徽省立医院麻醉科 通讯作者：方才 with respect to age, sex and body weight. The MAP and HR in groupⅠwere lower at T3，T4 than those at T0（p ( 0.05, p ( 0.01）. Comparing with groupⅠ, the MAP in group Ⅲ was significantly increased at T4（p ( 0.05）. MAP at T4 in group Ⅲ was significant lower than those at T0 in groupⅡ（p(0.05）. The blood glucose and cortisol at T2 and T3 we