听觉诱发电位指数在老年高血压患者丙泊酚靶控输注麻醉中的应用  

Application of auditory evoked potential index in the aged hypertensive patients during propofol anesthesia

作　　者：姚冰薇[1] 许波[1] 王雁娟[1] 

机构地区：[1]南京医科大学附属无锡人民医院麻醉科,无锡市214023

出　　处：《临床麻醉学杂志》2011年第6期535-537,共3页Journal of Clinical Anesthesiology

摘　　要：目的研究听觉诱发电位指数(AAI)在老年高血压患者丙泊酚靶控输注(TCI)中的应用。方法选择上腹部择期手术老年高血压患者50例,Ⅰ组行AAI监测对镇静深度反馈调控丙泊酚靶控输注,Ⅱ组根据HR、BP调控,每组25例。记录术前(T1)、插管(T2)、术中探查(T3)时的SBP、DBP,标准化丙泊酚剂量(μg.kg-1.min-1)、血压变异性(BPV),苏醒时间,血管活性药物使用人次及术中知晓情况。结果两组患者T2时SBP、DBP均低于T1时(P<0.05),组间差异无统计学意义。T3时Ⅱ组患者的SBP、DBP高于T1时和Ⅰ组(P<0.05)。Ⅰ组患者术中BPV小于Ⅱ组患者(P<0.05)。Ⅰ组患者术中丙泊酚剂量、苏醒时间及麻黄碱使用患者均少于Ⅱ组(P<0.05)。结论对于老年高血压患者,AAI监测可以很好的反应丙泊酚靶控输注时的麻醉深度。Objective To study the application of auditory evoked potential index （AAI） in the aged hypertensive patients during propofol anesthesia. Methods Fifty aged hypertensive patients undergoing selective upper abdominal surgery were randomly divided into two groups with 25 cases each. All the patients received propofol anesthesia in target controlled infusion （TCI） mode. The anesthesia depth was modulated by AAI in group Ⅰ or by heart rate and blood pressure in group Ⅱ. SBP and DBP were recorded at baseline （T1）, during intubation（T2 ） and intraoperative exploration （T3）. The standard dosage of propofol （μg-kg^-1·min^-1 ）, blood pressure variability （BPV）, recovery time, vocative drug usage and awareness during anesthesia were compared between the two groups. Results SBP and DBP at T2 were significantly lower than the baseline in both groups （P〈0. 05） and without significant difference between them. SBP and DBP in group Ⅱ were significantly higher at T1 than T2 and group Ⅰ （P〈0. 05）. BPV in group Ⅰ was lower than that in group Ⅲ （P〈0. 05）. The standard dosage of propofol, recovery time, the usage of ephedrine were lower in group I than those in group Ⅱ （P〈0.05）. Conclusion Auditory evoked potential index is a good indicator for the depth of anesthesia during propofol anesthesia in the aged hypertensive patients.

关 键 词：听觉诱发电位指数 丙泊酚 靶控输注 老年 全身麻醉 

分 类 号：R614[医药卫生—麻醉学]