安氟醚闭环靶控麻醉系统的临床应用  

A closed-loop volatile anesthetics target infusion system with enflurane

作　　者：王焕亮[1] 吴琦[1] 刘瑞芳[1] 赵连英[1] 类维富[1] 

机构地区：[1]山东大学齐鲁医院麻醉科,山东济南250012

出　　处：《山东大学学报（医学版）》2005年第11期1075-1078,1082,共5页Journal of Shandong University:Health Sciences

摘　　要：目的:探讨安氟醚靶控麻醉系统临床应用的安全性。方法:建立以脑电双频指数(BIS)为控制变量的吸入麻醉药靶控麻醉系统,对13例美国麻醉医师协会(ASA)Ⅰ～Ⅱ级结肠部分切除患者行安氟醚闭环靶控麻醉(T组),使用BIS执行误差中位数(MDPE)、执行误差绝对值中位数(MDAPE)、摆动度、补偿值对系统控制性能进行临床评价;观察麻醉期间患者血液动力学变化、苏醒期质量,并与传统人工控制麻醉组(H组,n=15)比较。结果:T组MDAP、MDAPE、摆动度和补偿值分别为(2.01±6.63)、(5.48±3.20)、(4.26±2.04)和(2.26±3.95);与H组比较,T组BIS值的摆动度较小(P=0.01),而MDPE、MDAPE、补偿值差异无统计学意义(P>0.05)。两组患者术中各时点血压、心率与基础值比较差异无统计学意义(P>0.05)。患者苏醒时间比较差异亦无统计学意义。结论:安氟醚闭环靶控麻醉系统能够将BIS控制在预定范围,患者麻醉深度和血液动力学稳定,该系统用于结肠部分切除患者的临床麻醉安全可行。Objective： To evaluate the performance of a closed-loop volatile anesthetics target-controlled infusion system with enflurane. Methods： A closed-loop volatile anesthetics target-controlled infusion system was built by using the bispectral index （BIS） as the control variable. Thirteen patients undergone colectomy were enrolled to be anesthesiaed by this system （T group）. The performance of the system was assessed by the median performance error （MDPE）, the median absolute performance error （MDAPE）, the wobble and the offset of BIS, as well as the stability of hemodynamics. The quality of emergence was observed and compared with the control group （H group, n=15）. Results： The MDPE,MDAPE,wobble and the offset were （2.01±6.63）, （5.48±3.20）, （4.26±2.04）and （2.26±3.95）respectively in the T group. The wobble was lower in the T group than that in the H group （P=0.01）. Other BIS performance indexes were not statistically different between the two groups （P〉0.05）. The cardiovascular variables were stable in both groups. Although there was oscillation between the measured BIS around the set point, no patients reported awareness or recall of intraoperative events. Conclusion： The system is able to provide adequate anesthesia with enflurane and keeps the hemodynamics stable in the colectomy patients.

关 键 词：脑电描记术 闭环控制 麻醉 吸入 麻醉药 

分 类 号：R614.2[医药卫生—麻醉学]