依托咪酯对人定量药物脑电图δ频段功率百分比影响.doc

依托咪酯对人定量药物脑电图δ频段功率百分比影响 　 作者：刘玲玲1，王立伟2，吴克俭3，戴体俊 【摘要】 目的 观察依托咪酯对人定量药物脑电图(quantitative pharmaco-EEG, QPEEG)δ频段功率百分比的影响。方法 选择志愿者20人，随机均分为2组，每组10人，男女各半，分别静脉注射0.2 mg/kg或0.3 mg/kg依托咪酯，观察、比较给药前后QPEEG的δ频段功率百分比。结果 静脉输注依托咪酯后，两组志愿者QPEEG的δ频段功率百分比均增加(P<0.01)，2～5 min达高峰，约10 min恢复。0.3 mg/kg组QPEEG δ频段功率百分比增加幅度大于0.2 mg/kg组(P<0.05或P<0.01)。结论 依托咪酯可剂量依赖性地增加人QPEEG的δ频段功率百分比，提示QPEEG的δ频段功率百分比可能成为监测依托咪酯麻醉深度的指标。 【关键词】 依托咪酯;定量药物脑电图;麻醉深度;δ频段;功率百分比 　　Abstract: Objective To investigate the effects of etomidate on the percentage of δ band power of quantitative pharmaco-EEG(QPEEG). Methods 20 healthy adults were divided randomly into 2 groups(groupⅠ,Ⅱ) with 10 in each and were given 0.2 mg/kg or 0.3 mg/kg etomidate by iv injections respectively. The EEG samples were obtained before and at regular intervals following the etomidate injections. Using power spectral analysis to check the EEG changes before and after the etomidate iv injections. Results The percentage of δ band power of QPEEG increased significantly in both of the group(P<0.01),and reached its peak 2～5 min,then returned normal in 10 min. The increasing of the percentage of δ band power of QPEEG in group Ⅱ is higher than group Ⅰ (P<0.05,P<0.01). Conclusion With the increasing etomidate dose, the percentage of power progressively increased at δ band, it was suggested that the percentage of power at δ band would be an effective means of anesthesia depth. 　　Key words: etomidate; QEPPG; anesthesia depth; δ band; the percentage of power 　　我们曾观察、报道了常用静脉麻醉药丙泊酚对兔定量药物脑电图(quantitative pharmaco-EEG, QPEEG)的影响，发现顶、枕叶结合部QPEEG变化最大，丙泊酚可使δ频段功率百分比增大，β1及β2频段功率百分比变小，且与丙泊酚的剂量有良好的相关性(在静注丙泊酚后20 s～20 min内，相关系数r在0.61～0.95之间，P<0.01)，其时效关系亦与行为学改变相一致[1]。我们最近发现，静脉麻醉药丙泊酚也可增加成人QPEEG δ频段的功率百分比(待发表资料)。由于丙泊酚的剂量与麻醉深度有很好的相关性，而丙泊酚的剂量又与QPEEG的改变有良好的相关性，提示QPEEG可能用于监测丙泊酚的麻醉深度。同时发现兔静注丙泊酚2.5 mg/kg后，兔翻正反射已消失，而QPEEG却无明显改变，表明控制翻正反射的中枢——中脑的抑制是在皮质(EEG反映皮质电活动)抑制之前。这说明QPEEG不仅可监测麻醉深度，还可分析药物的作用部位和顺序。依托咪酯和丙泊酚同为缺乏显著镇痛作用的镇静催眠类静脉麻醉药，它对人QPEEG的影响鲜见报道。我们对依托咪酯对健康志愿者QPEEG的