应用麻醉深度指数复合喉罩技术对老年患者下腹部手术静脉复合全麻监测的可行性研究.docVIP

应用麻醉深度指数复合喉罩技术对老年患者下腹部手术静脉复合全麻监测的可行性研究 　　【摘 要】目的：研究麻醉深度指数（CSI）复合喉罩技术用于老年患者下腹部手术静脉复合全麻的可行性。方法：择期选取经膀胱前列腺电切的老年患者48例，随机分为研究组和观察组，研究组通过维持CSI值于40-60左右来调节异丙酚的靶浓度值；观察组仅凭临床经验来调节异丙酚的浓度值。观察记录诱导前（To）、诱导后喉罩置入前（T1）、喉罩置入时（T2）、电切镜置入时（T3）、手术进行30min时（T4）、术终患者改良镇静清醒评分（OAA/S）≥4分时（T5）6个时间点的心率（HR）、收缩期压（SBP）、舒张压（DBP）、平均动脉压（MAP）和CSI。记录异丙酚和舒芬太尼的用量以及麻醉清醒时间，即停用异丙酚至术终患者改良镇静清醒评分（OAA/S）达4分时的时间。结果：研究组平均清醒时间为（9±2）min，观察组平均清醒时间为（15±5）min，两组间比较差异有统计学意义（P0.05）。研究组异丙酚的实际用量明显少于观察组，差异有统计学意义（P0.05）。T3、T4时研究组的CSI值明显高于观察组，差异有统计学意义（P0.05），观察组的SBP、DBP、MAP明显低于研究组。结论：通过CSI为麻醉深度监测提供量化指标，可有效应用于喉罩通气的老年患者短小手术静脉复合麻醉，减少麻醉药物的过量使用，具备可行性。 　　【关键词】麻醉深度指数；异丙酚；喉罩；全麻；老年 　　【中图分类号】R614 【文献标识码】A 【文章编号】1004-7484（2013）05-0168-02 　　To study the feasibility of cerebral state index for monitoring the depth of general anesthesla for the eldery with laryngeal mask anesthesia. 　　Li zheng xieng， chenfangji. 　　（The municipal hospital of Lai Xi Shandong 266600，China.） 　　【Abstract】objective：To study the feasibility of cerebral state index（CSI）modulating the depth of general anesthesia in the elderly with laryngeal mask anesthesia. Methods：48 ASA physical status of II-IIIpatients undergoing selective lower abdominal sutrery were divided two groups with 24 cases. The anesthesia was induced by sufentanil.propofuland mwintained with TCL propofol. The depth of unesthesia was modulated by CSI index in group I or by hemodynamics in group II. HR.SBP.SDP.MAP and CSI were recorded. The time of awakening form anesthesia（the time when OAA/S reached 4 score after the drawal of propofol）and the dosage of propofol and fentanyl were recored.Results：The time of awakening from anesthesia was 164min in rgoupII， which was significantly longer than that in group I（P0.05）. The total dosage of propofol in group I was significantly lower than used to predict the depth of anesthesis. Conclusion：CSI is Valuable in assessment of anesthetic depth during general anesthesis with laryngeal mask anesthesia in the elderly. 　　【Key words】Cdrebral state index（C