全麻诱导气管插管期听觉诱发电位与血糖变化观察  

The changes of auditory evoked potential and glucose during the induction phase of general anesthesia and endotracheal intubation

作　　者：冯昌盛[1] 杨小霖[1] 余庆波[1] 左友波[1] 陈恪刚[2] 

机构地区：[1]川北医学院附属医院麻醉科,四川省南充市637000 [2]贵阳医学院附属医院麻醉科,550004

出　　处：《实用医学杂志》2008年第10期1729-1731,共3页The Journal of Practical Medicine

摘　　要：目的:以听觉诱发电位指数(AAI)、血糖、血流动力学为观测指标,评估在全麻诱导气管插管期间三者的变化规律,探讨三者变化关系。方法:选择30例消化道恶性肿瘤患者(年龄40～65岁,MallampatiⅠ～Ⅱ,ASAⅠ～Ⅲ)。依次给予咪唑安定0.1mg/kg、异丙酚1.5mg/kg、维库溴胺0.1mg/kg、芬太尼2%g/kg,推药速度均为1mL/s,诱导完毕后以4mg/(kg·h)泵注异丙酚。注射芬太尼3min后气管插管,间歇正压通气,呼吸频率12～14次/min,潮气量8～10mL/kg,维持呼气末二氧化碳分压35～45mmHg。在麻醉诱导前,诱导完毕,插管前,插管后1、3、5、10、15min时点监测AAI、血糖(GLU)、心率(HR)以及血压[平均动脉压(MAP)、收缩压(SBP)、舒张压(DBP)]。结果:部分指标在诱导插管前后差异均有显著性,AAI在诱导前后变化最明显;GLU与SBP、DBP、MAP在诱导插管前后变化一致;AAI、HR在插管后3～15min后的变化趋势与SBP、DBP、MAP有所不同。结论:AAI在麻醉诱导期变化程度比GLU、血流动力学指标变化明显;GLU在麻醉诱导插管期与血压有相同的变化趋势,同步反映插管刺激;AAI在本研究条件下不能与血流动力学、血糖同步反映插管刺激。Objective To assess the changes of auditory evoked potential （AAI）, glucose （GLU）, and hemodynamics during the induction phase of general anesthesia and endotracheal intubation and to explore their relationship. Methods Thirty Mallampati Ⅰ - Ⅱ and ASA Ⅰ - Ⅱ patients aged 40 - 65 years with malignant digestive diseases were administered midazolam of 0.1 mg/kg, propofol 1.5 mg/kg, vecuronium 0.1 mg/kg, and fentanyl 2 ug/kg sequentially at a speed of 1 mL/s for anesthetic induction and then propofol of hourly 4 mg/kg. Endotracheal intubation was performed 3 min after fentanyl injection. AAI, GLU, HR, and BP （MAP, SBP and DBP） were measured at different time points. Results Some parameters altered markedly following induction and intubation, especially for AAI, and the changes in GLU level were similar with those in MAP SBP, and DBP. The tendency of alterations of AAI and HR differed with that of SBP, DBP, and MAP 3 to 15 min after intubation. Conclusions AAI alters more evidently than GLU and the hemodyamic parameters during the induction phase. GLU and BP have a similar tendency of alteration during induction and intubation, simultaneously signaling the responses to intubation; AAI, however, cannot reflect the same responses as GLU and hemodynamics do under the conditions of our research.

关 键 词：诱发电位 听觉 血糖 血流动力学 麻醉深度 

分 类 号：R614.2[医药卫生—麻醉学]