丙泊酚麻醉下静脉注射多巴胺对脑电监测指标及镇静评分的影响  

Effect of intravenous injection of dopamine on the bispectral index,entropy index,and sedation score during continuous propofol infusion

作　　者：薛纪秀[1] 徐国勋[1] 刘清海[1] 王克杰[1] 王天龙[1] 李冰[1] 杨利利[1] 

机构地区：[1]首都医科大学宣武医院麻醉科,北京100053

出　　处：《解放军医学杂志》2011年第11期1203-1206,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨丙泊酚麻醉下静脉注射多巴胺对脑电监测指标[双频谱指数(BIS)、熵指数]及镇静评分(OAA/S)的影响。方法选择9例ASAⅠ-Ⅱ级全麻下手术患者,给予丙泊酚镇静麻醉,当OAA/S=2时,维持此时血浆/效应室浓度(Cp/Ce)不变,静脉单次注射多巴胺3～5mg,记录注射前1min、注射后第1～5min内BIS、熵指数[反应熵(RE)和状态熵(SE)]、OAA/S评分及平均动脉压(MAP)的变化。结果 OAA/S=2时的Cp/Ce为1.71±0.42;静脉注射多巴胺后,5例BIS显著升高,4例BIS>70,增高值主要集中在第3、4min内;9例熵指数自第2min起呈上升趋势,6例与注射前比较明显增加,并且RE、SE差值增加;BIS及熵指数的增高迟于MAP的增高;5例OAA/S评分≥4。结论丙泊酚镇静麻醉下,OAA/S=2时静脉注射多巴胺可出现BIS、熵指数及镇静评分增加现象,具有唤醒作用;熵指数在反映多巴胺唤醒效应时更敏感。Objective To examine the effect of an intravenous injection of dopamine on the bispectral index（BIS）,entropy index,and sedation score [Observer’s Assessment of Alertness/Sedation（OAAS）] during continuous propofol infusion.Methods The present study selected nine patients undergoing an operation under ASA Ⅰ-Ⅱ general anesthesia.Propofol is administered for anesthesia,and plasma/effective concentration（Cp/Ce） remained unchanged when OAA/S=2.An intravenous injection of dopamine is then administrated at a single injection dosage of 3 mg to 5 mg.BIS,response entropy（RE）,state entropy（SE）,OAA/S score,and mean arterial pressure（MAP） are recorded 1 min before injection and 1 min to 5 min after injection.Results Cp/Ce is 1.71±0.42 when OAA/S=2.After the intravenous injection of dopamine,BIS increases remarkably in five cases（BIS〉70 in four cases）.The increment primarily occurs at 3 and 4 min.The entropy index in nine cases begins to increase at 2min,with this index apparently higher than that before the injection in six cases.The difference between RE and SE increases,and the increment of BIS and the entropy index occurs later than MAP.The OAA/S score ≥4 in five cases.Conclusion Intravenous injection of dopamine results in higher BIS,entropy index,and sedation score during a continuous infusion of propofol when OAA/S=2,thereby having an arousal effect.The entropy index is sensitive in terms of reflecting the arousal effect of dopamine.

关 键 词：二异丙酚 麻醉 多巴胺 双频谱指数 熵 镇静评分 

分 类 号：R614[医药卫生—麻醉学]