七氟醚麻醉下不同剂的量舒芬太尼对气管插管时BIS、Narcotrend的影响.doc

七氟醚麻醉下不同剂量舒芬太尼对气管插管时BIS、Narcotrend的影响 王荣宁 郭曲练 刘松华 [摘要] 目的：观察七氟醚麻醉下应用不同剂量的舒芬太尼，对气管插管时BIS、Narcotrend的影响大小。方法：选择48例妇科患者，ASAⅠ～Ⅱ级，年龄20～49岁，全麻下行择期腹腔镜手术患者，随机分为A、B、C、D四组（n=12）D组复合应用舒芬太尼，剂量分别为0.25μg/kg、0.5μg/kg、1.0μg/kg，A组给予生理盐水2ml），行控制呼吸，调整氧流速，待各组七氟醚呼气末浓度上升至2.0MAC，维持2min后行气管插管，观察3min后结束实验。连续监测BIS、Narcotrend，同时记录麻醉诱导前（t0）、患者意识消失时（t1）、气管插管前（t2）、气管插管后1min（t3）、气管插管后3min（t4）的血流动力学。结果:四组的BIS、Narcotrend值在患者意识消失时、气管插管前均较麻醉诱导前明显下降（P 0.05）;各组气管插管后BIS的上升程度随舒芬太尼剂量的增大而减小，相关有统计学意义（P 0.001）；各组Narcotrend值在气管插管前后无明显变化（P 0.05）。结论：在七氟醚麻醉下，舒芬太尼呈剂量依赖性的减小患者气管插管后BIS的上升程度；Narcotrend显示气管插管反应不灵敏。 [关键词] 七氟醚；舒芬太尼；脑电描记术；麻醉深度 The influence of sulfentanil with various doses on the Bispectral index and Narcotrend index during the ototracheal intubation under the anestheaia of sevoflurane Wang Rong Ning,Guo Qu Lian,Liu Song Hua. Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha 410008 China. [Abstract]Objective:To observe the influence of sufentanil with various doses on the Bispectral index and Narcotrend index during the ototracheal intubation under the anesthesia of sevoflurane. Methods:Forty eight ASAⅠ～Ⅱpatients undergoing gynecological operations were randomly divided into four groups.Group A:placebo;Group B:sufentanil 0.25μg/kg;Group C: 0.5μg/kg;Group D: 1.0μg/kg(all injected intravenous before the ototracheal intubation).The index of Bispectral and Narcotrend were recorded continuously during the induction and ototracheal intubation. Results:The indices of Bispectral and Narcotrend in all groups were all significant lower in the timepots of the LOC (Loss of consciousness) and preototracheal intubation than those in preinduction（P 0.05）P 0.001);the Narcorend index in all groups were not significant changable pre and post ototracheal intubation（P 0.05） Conclusion:Under the anesthesia of sevoflurane,sufentanil decreased the tendency of the Bispectral index rising dose-dependently;the Narcotrend index was insensitive in the prediction of the reaction to the ototra