不同全麻诱导用药对心脏手术患者BIS、MAP和HR的影响  

Changes of bispectial index and hemodyamics in heart operations patients during endotracheal intubation anaesthesia

作　　者：王瑞婷[1] 方才[1] 魏昕[1] 康芳[1] 

机构地区：[1]安徽省立医院,安徽合肥230001

出　　处：《山东医药》2006年第33期3-4,共2页Shandong Medical Journal

基　　金：安徽省卫生厅科研基金资助项目(2002B061)

摘　　要：目的观察不同麻醉诱导用药对脑电双频指数（BIS）、MAP和HR的影响。方法将40例心脏直视手术患者。随机分为依托咪酯组（E组）和异丙酚组（P组），每组20例。E组采用眯唑安定0．2mg／kg、依托眯酯0．3mg／kg、芬太尼6μg／kg、琥珀胆碱1．5～2．0mg／kg静注，P组采用咪唑安定0．2mg／kg、丙泊酚1mg／kg、芬太尼6μg／kg、琥珀胆碱1．5～2．0mg／kg静注气管插管。分别记录各时点BIS、MAP、HR值。结果两组麻醉诱导后BIS值随麻醉加深进行性降低（P＜0．01），组间比较有显著性差异（P＜0．05）。与麻醉前基础MAP相比．诱导及插管期E组MAP无显著变化（P＞0.05），P组MAP在静注丙泊酚后明显降低．与基础MAP相比差异显著（P＜0．05）。两组HR无明显波动（P＞0．05）。结论 依托眯酯或异丙酚联合阿片类药进行全麻诱导，皆可获得满意麻醉深度和同等BIS水平．但依托咪酯扩血管作用较弱，较异丙酚安全。[Objective] To investigate the changes of BIS and hemodynamics during endotracheal intubation anaesthesia [Methods] Forty patients undergoing elective open heart surgery with CPB were randomly divided group E were injected with midazolam 0. 2 mg/kg,etomidate 0.3 mg/kg,fentany 6 μg/kg,succlnylcholine 1.5-2.0 mg/kg,and patients in group P were injected with midazolam 0. 2 mg/kg,propofol 1 mg/kg,fentany 6 μg/ kg,succinylcholine 1.5-2.0 mg/kg. BIS,MAP and HR were continuously monitored and recorded. [Results] BIS decreased significantly along with anaesthesia induction deepening in two groups （P 〈 0.01）and had significant difference between the two groups （P 〈 0.01）.MAP in E group had no significant difference compared with the base MAP. MAP was significantly decreased in group P after infusion of propofol （P 〈 0.05）. There was no significant difference of the HR between the two groups （ P 〉 0.05）. [Conclusion] For patients with cardiac surgery,anesthesia induced with etomidate or propofol can offer adequate depth of general anesthesia,but etomidate is less vasodilator and more safe.

关 键 词：依托咪酯 异丙酚 麻醉诱导 脑电双频指数 血压 心率 

分 类 号：R971.2[医药卫生—药品] R541.1[医药卫生—药学]