靶控输注不同浓度舒芬太尼对丙泊酚TCI镇静催眠的影响  

Effects of different TCI concentrations of sufentanil on sedation and hypnosis effects of TCI propofol

作　　者：贾瑞芳[1] 王巧恒[1] 左明章[1] 华震[1] 

机构地区：[1]卫生部北京医院麻醉科,100730

出　　处：《北京医学》2011年第1期37-40,共4页Beijing Medical Journal

摘　　要：目的在麻醉诱导期观察靶控输注(TCI)不同浓度舒芬太尼对丙泊酚镇静催眠效应的影响。方法 60例择期手术全麻患者,年龄25～60岁,ASAⅠ～Ⅱ级。随机分为4组,每组15例。A组为单纯丙泊酚组;B、C、D组为丙泊酚+舒芬太尼组,舒芬太尼的靶效应浓度分别为0.1、0.2、0.3ng/ml。B、C、D组在TCI舒芬太尼达平衡后,TCI丙泊酚。记录舒芬太尼达平衡后1min和丙泊酚效应浓度达1.0、1.5、2.0、2.5、3.0μg/ml时的脑电双频谱指数(BIS)和OAA/S评分。结果在单纯输注舒芬太尼期间,BIS和OAA/S评分无明显变化;随丙泊酚浓度升高,患者BIS和OAA/S评分逐渐下降;相同丙泊酚浓度时,各组间的BIS值无明显差别;丙泊酚浓度为1.0、1.5、2.0μg/ml时,D组的OAA/S评分(4.1±0.3、4.3±0.7、3.1±1.1)明显低于A组(4.1±0.7、3.1±1.3、2.1±1.0,P<0.05)。结论麻醉诱导期间输注0.1ng/ml和0.2ng/ml浓度的舒芬太尼不增强丙泊酚的镇静催眠效应,0.3ng/ml的舒芬太尼可以增加丙泊酚的镇静催眠效应。Objective To estimate the effects of TCI different concentrations of sufentanil on sedation and hypnosis effects of TCI propofol. Methods Sixty patients, ASAⅠ～Ⅱ, aged 25～60 years old, were enrolled and divided randomly into four groups. Group A received TCI propofol alone, group B, C and D received TCI sufentanil before TCI propofol and effect site target concentration（Ct） of sufentanil were 0.1, 0.2 and 0.3 ng/ml respectively. Target concentration （Ct） of propofol was increased step-by-step from 1 to 3 μg/ml in five steps. Only after the Ct of propofol was maintained at each step for 1 min, OAA/S and bispectral index （BIS） were recorded. OAA/S and BIS were also recorded after 1 min of Ct of sufentanil was reached. Results TCI sufentanil alone did not affect patients’ BIS and OAA/S. BIS and OAA/S decreased with increase of propofol Ct in all groups. At the same Ct of propofol, there was no significant difference in BIS among all groups. OAA/S in group D was significantly lower than that in group A when the Ct of propofol was 1.0～2.0 μg/ml （P〈0.05）. Conclusions During period of induction, sufentanil of effect concentrations at 0.1 and 0.2 ng/ml does not enhance sedation and hypnosis effects of propofol. Sufentanil in 0.3ng/ml may enhance sedation and hypnosis effects of propofol.

关 键 词：舒芬太尼 丙泊酚 靶控输注 镇静催眠 

分 类 号：R614[医药卫生—麻醉学]