艾司洛尔复合芬太尼对七氟醚诱导气管插管BIS和NI值的影响  

Effects of Esmolol Combined with Fentanyl on Bispectral Index and Narcotrend Index During Sevoflurane Anesthesia

作　　者：夏萍萍[1] 梁思[1] 叶治[1] 钟涛[1] 郭曲练[1] 

机构地区：[1]中南大学湘雅医院麻醉科,湖南长沙410003

出　　处：《医学临床研究》2009年第12期2242-2245,共4页Journal of Clinical Research

摘　　要：【目的】探讨艾司洛尔复合芬太尼是否能抑制七氟醚麻醉诱导气管插管反应，保持满意的麻醉深度以及艾司洛尔是否能减少芬太尼的用量。【方法】ASAⅠ～Ⅱ级择期行下腹部手术患者75例，随机均分为五组。Ⅰ组：生理盐水对照组；Ⅱ组：艾司洛尔组；Ⅲ组：艾司洛尔＋芬太尼3gg／kg组；Ⅳ组：芬太尼6beg／kg组；Ⅴ组：芬太尼3μg／kg组。全部采取七氟醚面罩吸入12min复合罗库溴铵1mg／kg麻醉诱导气管插管，行经口明视气管插管。监测并记录诱导开始时（T1）、插管前（T2）、插管后1、2、3、5、8min（T3、T4、T5、T6、T7）的脑电双频谱指数（BIS）、Narcotrend指数（NI）、心率（HR）、收缩压（SBP）、舒张压（DBP）值，并观察插管前与插管后各时点的各项指标变化。【结果】：与基础值（T1）相比，五组病人诱导后HR、MAP、BIS、NI均下降（P〈0．05）。Ⅱ组与Ⅰ组相比，插管前HR、MAP、BIS、NI无明显差异（P〉0．05）。而Ⅰ组在插管后1、2、3、5min（T3、T4、T5、T6）各时点的HR、MAP、BIS、NI均高于Ⅱ组（P〈0．05）。Ⅲ组与其它4组相比，插管前HR、MAP、BIS、NI无明显差异（P〉0．05）。除Ⅳ组外，其余各组在插管后1、2、3、5min（T2、T4、T5、T6）各时点的HR、MAP、BIS、NI均高于Ⅲ组（P〈0．05）。Ⅳ组与Ⅲ组插管前后HR、MAP、BIS、NI均无明显差异（P〉0．05）。[Objective] To investigate whether esmolol combining fentanyl can inhibit the orotracheal intubation reaction and keep satisfying depth of anesthesia during sevoflurane anesthesia and whether esmolol can reduce the demanded quantity of fentanyl. [Methods] ASA grade I - II 75 patients scheduled for hypogastric surgery were randomized into five groups （ n = 15 in each）. Group I were given saline, group II were given esmolol, group III were given esmolol and fentanyl （3 μg/kg）, group IV were given 6 μg/kg fentanyl and group V were given 3μg /kg fentanyl. The entire anesthesia was induced by sevoflurane inhaled via oxygen mask for 12min combining rocuronium 1mg/kg, and then orotracheal intubation was conducted. Heart rate （HR）, systolic pressure（SP）, diastolic pressure（DP）, bispectral index（BIS） and Narcotrend index（NI） we＇re monitored and recorded before induction （T1）, before intubation （T2） and at 1,2,3,5,8 minute after intubation（T3 ,T4 ,Ts ,T6 ,TT）. [Results] The HR, MAP, BIS and NI values of all the 5 groups decreased compared with basic value T1 （ P 〈0.05）. The HR, MAP, BIS and NI value of esmolol group （group II ） before intubation presented no significant differences compared with that of saline group （group I ） （ P 〉0.05）. Howev er, the HR, MAP, BIS and NI values of group I measured at 1,2,3,5 minutes after intubation （T3, T4, T5, T6） were all higher than those of group II （ P 〈0.05）. The HR, MAP, BIS and NI values of group III before intubation showed no significant differences compared with those of the rest four groups （ P 〉0.05）. The HR, MAP, BIS and NI values of group III measured at 1,2,3,5 minutes after intubation （T3, T4, T5, T6） were lower than those of the rest groups except group IV （ P d0.05）. The HR, MAP, BIS and NI values be fore and after intubatipn of group III and IV presented no significant differences（ P 〉0.05）. [Conclusion] Esmolol combined with Fentanyl can keep a satisfying depth of anesthesi

关 键 词：插管法 气管内 丙醇胺类/投药和剂量 芬太尼/投药和剂量 醚类 

分 类 号：R472.9[医药卫生—护理学]