指脉搏图波幅变化与全凭静脉麻醉药物作用的相关性  

Correlation between pulse oximetry plethysmographic waveform amplitude and anesthetic effects from total intravenous anesthesia

作　　者：徐磊[1] 仲艳玲[2] 朱中良[1] 朱娟[1] 鲍红光[1] 

机构地区：[1]南京医科大学附属南京第一医院麻醉科,210006 [2]南京市第二医院麻醉科

出　　处：《临床麻醉学杂志》2011年第11期1056-1058,共3页Journal of Clinical Anesthesiology

基　　金：南京医科大学科技发展重点基金项目资助(07NMUZ041)

摘　　要：目的评价指脉搏图形分析技术用于监测全身麻醉药物作用及机体伤害性刺激反应的可行性及有效性。方法 72例择期行甲状腺或乳腺手术的患者,随机均分为舒芬太尼组(SF组)和芬太尼组(F组)。观察患者入室时(T1,基础值)、诱导后1min(T2)、3min(T3)、5min(T4)、气管内插管即刻(T5)、插管后1min(T6)、3min(T7)、外科切皮时(T8)时的HR、SBP、DBP和SpO2。连续监测指脉搏波幅(POPWA)变化,分析其与麻醉药物作用程度及机体刺激反应的相关性。结果 T8时两组HR快于T1时,T5时快于T4时(P<0.05);T8时F组HR明显慢于SF组(P<0.05)。T4～T8时两组SBP及DBP低于T1时,T3时低于T2时(P<0.01);两组POPWA与诱导后SBP与DBP变化呈负相关(P<0.01),与HR无明确相关性。结论 POPWA变化与全凭静脉麻醉作用程度呈正相关,与伤害性反应强度呈负相关。Objective To evaluate the efficacy and feasibility of pulse oximetry plethysmographic waveform amplitude in monitoring anesthetic effects and reaction to noeiceptive stimulation. Methods Seventy-two patients undergoing thyroid or breast surgeries were randomly divided into fentanyl group （group F） and sulfentanil group （group SF）. HR, SBP, DBP, SpO2 were recorded at following time points： into operation room （T1）, 1 min （T2）, 3 min （T3） and 5 min （T4） after induntion, intubation immediate （T5）, 1 min （T6） and 3 min （T7） after intubation, immediate of surgery beginning （T8）. Pulse oximetry plethysmographic waveform amplitude （POPWA） in both groups was analyzed and the correlation was explored between POPWA and nociceptive stimulus and stress reaction. Results HR in both groups was faster at T8 than at T1, and faster at T5 than at T4 （P〈0. 05） ; in addition, HR in group F was slower than group SF at T8 （P〈0. 05）. SBP and DBP in two groups were lower at T4-T5 than at T1 ,and lower at T3 than at T2 （P〈0.01）. POPWA displayed negative relationship to SBP and DBP （P〈 0. 01）, but no correlation was found between HR. Conclusion POPWA is positively related with intravenous anesthetic depth, but negatively associated with nociceptive intensity.

关 键 词：全凭静脉麻醉 麻醉深度 指脉搏波图形分析 伤害性刺激反应 

分 类 号：R614[医药卫生—麻醉学]