七氟醚诱导气管插管时表面麻醉对熵指数的影响论文.pdf

摘 要 七氟醚诱导气管插管时表面麻醉对熵指数的影响 研究生:李红宝 导师:徐志新 摘 要 目的：熵指数是一种新的麻醉深度监测方法，有研究认为较原有的监测方法能 更好的监测伤害性刺激。全麻插管时对病人的伤害性刺激会产生很严重的后果，我 们研究七氟醚吸入诱导气管插管时，表面麻醉对熵指数的影响。方法：ASA I-II 级 30 例择期腹腔镜手术病人，随机分为试验组（七氟醚+利多卡因组 L 组）和对照组(七 氟醚+生理盐水组 S 组) ，先给予镇静剂量的咪唑安定(0.05mg/kg)后，吸入七氟醚后 气管插管。监测入室、插管前、插管时各点的及插管后 1，2 ，3 分钟时点的反应熵、 状态熵、平均动脉压、心率值。结果：对照组（七氟醚+生理盐水组 S 组），插管时， 插管后 1 分钟，状态熵、反应熵、心率均明显升高，试验组（七氟醚+利多卡因组 L 组）反应熵、状态熵、平均动脉压、心率变化不明显。反应熵和状态熵之间未见明 显差异。结论：在七氟醚诱导气管插管时，应用利多卡因进行表面麻醉可以明显抑 制熵指数数值的变化， 关键词：熵指数；七氟醚；表面麻醉；伤害性刺激 —1— 新疆医科大学医学硕士学位论文 Effect of Topical Anesthesia on Entropy during the Tracheal Intubation with Sevoflurane Anesthesia postgraduate: Li Hongbao tutor:Xu Zhixin Abstract Objective: to investigate the effect of Topical Anesthesia on Entropy during tracheal intubation with sevoflurane Methods: thirty patients of ASA class Ⅰ- Ⅱ undergoing elective laparoscopic surgery were randomized into four groups with 15 cases each. （groupL and groupS ）.all patients received sedative dose of midazolam (0.05mg/kg ) and O2 6 ～4 L/min by a facemask at the same time for 3 minutes before induction , Sevoflurane was inhaled from the concentration of 8% ,according to the data of RE/SE to adjust the concentration of Sevoflurane , and maintaining RE/SE 40 for 5min, Lidocaine(L) or normal Saline(S) 5ml was given in trachea espectively, another 5min were needed sustaining RE/SE between 25-40, and tracheal intubation was performed. The date for SE RE MAP HR were recorded before induction and the time point of 0,1 , 2 ,3 minute after intubation. Results: the date of SE RE