麻醉深度指数(CSI)用于老年患者喉罩全麻麻醉深度监测的研究  

Cerebral State Index for Monitoring the Depth of General Anesthesia for the Elderly with Laryngeal Mask Anesthesia

作　　者：杨占民[1] 卢兰生[1] 边磊[1] 

机构地区：[1]北京大学航天临床医学院麻醉科,100049

出　　处：《医学研究杂志》2009年第6期58-60,共3页Journal of Medical Research

摘　　要：目的研究麻醉深度指数(CSI)复合喉罩技术用于老年患者下腹部手术静脉复合全麻的可行性。方法择期行经膀胱前列腺电切的老年患者24例,随机分为两组,Ⅰ组通过维持CSI值于40～60左右来调节异丙酚的靶浓度值;Ⅱ组仅凭临床经验来调节异丙酚的靶浓度值。观察记录诱导前(T0)、诱导后喉罩置入前(T1)、喉罩置入时(T2)、电切镜置入时(T3)、手术进行30min时(T4)、术终患者改良镇静清醒评分(OAA/S)≥4分时(T5)6个时间点的心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)和CSI。记录异丙酚和舒芬太尼的用量以及麻醉清醒时间,即停用异丙酚至术终患者改良镇静清醒评分(OAA/S)达4分时的时间。结果Ⅰ组平均清醒时间为(9±3)min,Ⅱ组平均清醒时间为(15±6)min,两组间比较差异有统计学意义(P<0.05)。Ⅰ组异丙酚的实际用量明显少于对照组,差异有统计学意义(P<0.05)。T3、T4时点Ⅰ组的CSI值明显高于Ⅱ组,差异有统计学意义(P<0.05),Ⅱ组的SBP、DBP、MAP明显较Ⅰ组低。结论通过CSI为麻醉深度监测提供量化指标,可有效应用于喉罩通气时的老年患者短小手术静脉复合麻醉,减少麻醉药物的过量使用。Objective To study the feasibility of cerebral state index（CSI） modulating the depth of general anesthesia in the elderly with laryngeal mask anesthesia. Methods Tmenty - four ASA physical status of Ⅱ - Ⅲ patients undergoing selective lower abdominal surgery were divided two groups with 12 cases. The anesthesia was induced by sufentanil. propofuland maintained with TCI propofol. The depth of anesthesia was modulated by CSI index in group Ⅰ or by hemodynamics in group Ⅱ . HR,SBP,DBP,MAP and CSI were recorded. The time of awakening form anesthesia （ the time when OAA/S reached 4 score after the drawal of propofol） and the dosage of propofol and fentanyl were recored. Results The time of awakening from anesthesia was 16 ± 5rain in group Ⅱ , which was significantly longer than that in group Ⅰ（ P 〈 0.05 ）. The total dosage of propofol in group Ⅰ was significantly lower than that in group Ⅱ（ P 〈 0.05 ）. The value of CSI could be used to predict the depth of anesthesia. Conclusion CSI is valuable in assessment of anesthetic depth during general anesthesia with laryngeal mask anesthesia in the elderly.

关 键 词：麻醉深度指数 异丙酚 喉罩 全麻 老年 

分 类 号：R614[医药卫生—麻醉学] R472.3[医药卫生—外科学]