脑电双频指数和麻醉趋势指数用于老年患者丙泊酚麻醉深度的观察  

Use of bispectral index and narcotrend monitor in inspecting the depth of anesthesia in elderly patients in-duced different doses of propofol infusion

作　　者：赵立明[1] 吴丽霞[3] 杨宝慧[2] 麻海春[1] 

机构地区：[1]吉林大学白求恩第一医院麻醉科,吉林省长春,130021 [2]黑龙江省大庆油田总医院麻醉科 [3]黑龙江省大庆龙南医院麻醉科

出　　处：《中国基层医药》2011年第19期2625-2627,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察不同剂量丙泊酚静脉麻醉老年患者的脑电双频指数（BIS）和麻醉趋势指数（NI）的变化。方法行择期手术的100例老年患者随机均分为五组，分别采用5种不同剂量丙泊酚静脉麻醉方式，丙泊酚用量分别为：I组0．5mg／kg、11组0．75mg／kg、Ⅲ组1．0mg／kg、1V组1．25mg／kg和V组1．5mg／kg，注射时间均为1min。观察比较各组注药前、注药后1rain和5rain时心率（rm）、平均动脉压（MAP）、BIS及NI值变化情况。结果各组HR在组内、组间差异均无统计学意义（均P〉0．05）；注药后1min时，各组MAP均于显著低于注药前（t=2．17、2．84、2．49、5．63、7．10，均尸〈0．05），同时Ⅳ和V组低于I、Ⅱ和Ⅲ组（t=4．67、2．77、2．45、5．49、4．57、2．18，均P〈0．05）；注药后5rain时，各组HR和MAP与注药差异均无统计学意义（均P〉0．05）。注药后1rain时，各组BIS及NI均显著低于注药前（t=7．74、11．74、28．18、30．34、45．28、6．65、10．52、17．27、26．28、30．14，均P〈0．05），并随丙泊酚剂量的增加，BIS呈降低趋势，同时Ⅲ组、Ⅳ组和V组BIS值较I组和Ⅱ组明显降低（t=12．59、11．08、16．72、15．12、17．67、15．64，均P〈0．05）；注药后5rain时，各组BIS及NI与注药前差异均无统计学意义（均P〉0．05）；丙泊酚剂量与BIS和NI之间呈直线负相关关系（r=0．898、0．930，均P〈0．05）。结论BIS和NI可准确监测老年患者的麻醉深度，丙泊酚1．0mg／kg静脉注射可满足老年患者静脉麻醉的需求，且循环平稳。Objective To observe the changes of HR, MAP,BIS and Narcotrend induced by different doses of propofol in elderly patients. Methods One hundred elder patients （ 60 - 85 years old）, ASA classI orⅡ, sched- uled for selective surgeries,were divided equally into 5 different doses of propofol（ constant intravenous injection for l min） groups of 0.5mg/kg（ I ） ,0.75mg/kg（ Ⅱ ）, 1.0mg/kg（Ⅲ ）, 1.25mg/kg（ IV ）and 1.5mg/kg（V）. HR, MAP, BIS and Nareotrend were monitored before propofol injection and at 1 and 5 min after propofol injection. Results HR of 5 group s as similar. At 1 rain after propofol injection,MAP decreased remarkably compared with at before in all 5 groups（ t = 2.17,2.84,2.49,5.63,7.10, allP 〈 0.05 ）, which in group IV and V decreased significantly compared with at in group I , II and III（t=4.67,2.77,2.45,5.49,4.57,2.18,allP〈0.05）.At 1 rain after propofol injec- tion,BIS and NI values decreased compared with at before in all 5 groups（t =7.74,11.74,28.18,30.34,45.28, 6. 65,10.52,17.27,26.28,30. 14, allP 〈 0.05 ）, which in group II/, IV and V were significantly lower than those in group I and I1 （ t = 12.59,11.08,16.72,15.12,17.67,15.64, allP 〈 0.05 ）. Dose of propofol was negatively corre- lated with BIS and NI value （ r = -0. 898/0. 930, P 〈 0. 01 ）. Conclusion Propofol 1.0mg/kg constant injection should meet the sedation and hypnosis demand of general anesthesia in elderly patients and could not inhibit circulato- ry system; Bispectral Index and Nareotrend could accuratly monitor depth of anesthesia in elderly patients.

关 键 词：麻醉 脑电双频指数 麻醉趋势指数 二异丙酚 老年人 

分 类 号：R614[医药卫生—麻醉学]