布托啡诺对患者呼吸功能和脑电双频指数的影响.docVIP

布托啡诺对患者呼吸功能和脑电双频指数的影响 叶飞 佘守章 邬子林 (广州医学院附属市一人民医院 广州 510180) 【摘要】 目的：观察与评价静脉注射布托啡诺（butorphanol）对患者呼吸功能和脑电双频指数（BIS）的影响。方法：选择择期手术病人45例，ASAⅠ-Ⅱ级，年龄20-55岁，体重50-80kg,随机分成三组，麻醉前预注布托啡诺：Ⅰ组10ug/kg, Ⅱ组20ug/kg, Ⅲ组30ug/kg，每组15例。观察给药前(T0)、给药后T1, T3,T5,T7,T10,T15,T20,T30各时点的VT、、RR、Spo2、PETCO2、Mv、HR、BP等呼吸力学和血流动力学参数及麻醉深度脑电双频指数（BIS）。结果：Ⅰ组、Ⅱ组病人的RR、VT、Mv在注药后与基础值比较均无明显差异，差异无统计学意义(P0.05), Ⅲ组病人注药后1min，3min，7min的RR 、VT显著低于基础值 (P0.05)，三个时点RR降低程度分别是28.2%,24.3%,24.3%,三个时点VT降低程度分别是31.0%，17.0%，22.1%; Ⅲ组病人注药后1min，3min，5min,7min Mv显著低于基础值 (P0.05), 四个时点Mv降低程度分别31.1%,48.5%,36.2% 33.4%。Ⅰ组、Ⅱ组病人BIS值与基础值比较的差异不显著，（P0.05）, Ⅲ组病人在注药后3min至30min时点BIS值明显下降(P0.01)，且OAA/S评分也下降（P0.05）。结论：静脉注射30ug/kg布托啡诺对患者呼吸功能有抑制，但呼吸抑制的持续时间较短(10min以内)，且有轻度镇静作用,可以引起脑电双频指数的下降。 【关健词】布托啡诺 呼吸功能 脑电双频指数 Effects of intravenous injection of butorphanol on the Respiratory function and Bispectral index of patient. YE Fei; SHE Shou-zhang;WU Zi-Lin;et al. Department of Anesthesiology; Guangzhou First Municipal Peoples Hospital; Guangzhou Medical College; Guangzhou 510180; China 【Abstract】 Objective to investigate the effects of the intravenous injection of different doses of butorphnol on Respiratory function and bispectral index. Methods fortyfive patients ，aged 20-55,weight 50-80kg ,with ASA gradeⅠ-Ⅱ,undergoing selective surgery,were randomly allocated into three groups of 15 patients each,namely goup Ⅰ、Ⅱ、Ⅲ。Group Ⅰ:intravenous Injection with butorphanol 10ug.kg-1 before anesthesia; group Ⅱ: intravenous Injection butorphanol 20ug.kg-1 before anesthesia, group Ⅲ:intravenous Injection butorphanol 30ug.kg-1. Observe the parameters of Breathing mechanics and haemodynamics:VT、RR、Spo2、PETCO2、Mv、HR、BP and the Bispectral index and OAA/S score in each time points that is before administration(T0) and after it(T1, T3,T5,T7,T10,T15,T20,T30). Results No significant change occurred in respiratory rate(RR),tidal volume(VT),minute volume of ventilation(Mv) in group Ⅰand groupⅡ((P0.05),but in group Ⅲ RR and VT decreased dramatically at 1 mi