脑电双频指数BIS 对异丙酚镇静深度调控作用.docVIP

脑电双频指数BIS 对异丙酚镇静深度调控作用 　　【摘要】目的:探讨脑电双频指数对异丙酚镇静深度的调控作用。方法:60例ASAI~II级择期在颈丛阻滞下行甲状腺次全切除术患者,随机分为对照组和调控组,每组30例。术中持续输注异丙酚,对照组4~8mg?kg-1?h-1,调控组依据BIS值(40~60)维持输注速率。记录术中异丙酚维持用量、发声时间、术毕定向力恢复时间。结果:调控组异丙酚维持用量明显少于对照组,P0.05;调控组的发声时间、术毕定向力回复时间显著短于对照组,P0.05。结论:在颈丛阻滞下行甲状腺次全切除术,脑电双频指数是调控异丙酚镇静深度的有效指标。 　　【关键词】脑电双频指数;异丙酚;镇静;调控作用 　　【中图分类号】R971.3 【文献标识码】A 【文章编号】1008-6455(2010)08-0217-01 　　Effect of propofol for consciousness sedation by BIS feedback 　　Wen Laiyou Chen Jianqing Miao Jianzhong Wu Zhen Huang Bing LiFeng 　　【Abstract】Objective:To investigate the feasibility of propofol for conscious sedation by BIS feedback. Methods Sixty ASA I~II patients undergoing elective thyroidectomy with cervical plexus block were enrolled in this study.The patients were randomly divided into 2 groups(n=20 in each group). The patients in group regulation were given intravenous infusion of propofol at the dose of making BIS of 40~60, while those in group control were given propofol at the dose of l 4~8mg?kg-1?h-1. The amount of propofol used for intravenous infusion and phonation time as well as time of recovery about directive force were recorded. Results:The dose of propofol for intravenous infusion in group regulation was (268.48±38.74) mg which was significantly less than (342.34±32.35) mg in group control (P0.05). Phonation time and time of recovery about directive force in group regulation were obviously lower than those in group control (P0.05). Conclusion:BIS can be used as an effective indicator to regulated sedation of propofol by intravenous infusion in patients undergoing elective thyroidectomy with cervical plexus block. 　　【Key words】BIS; Propofol;Sedation;Feedback control 　　 　　颈丛阻滞下行甲状腺手术,因体位、牵拉、压迫等操作可致病人不适感,术中常辅以镇静、镇痛药[1]。但用药量无法保证术中及时让病人恢复神智发声以确认喉返神经有无损伤,我们应用脑电双频指数(BIS)调控异丙酚术中镇静深度,取得很好的效果,现报道如下。 　　1 资料与方法 　　1.1 一般资料:2009年10月~2010年6月60例ASAI~II级择期在颈丛阻滞下行甲状腺次全切除术患者,随机分为对照组和调控组,每组30例。其中男24例,女36例,年龄23岁~65岁,体重43kg~64kg,术前无高血压、心血管疾病及糖尿病病史。 　　1.2 方法:术前30min肌注阿托品0.5mg、鲁米那0.1g,入室后常规监测血压