昼夜节律对丙泊酚麻醉深度的影响  

Influence of Circadian Rhythm on Depth of Propofol Anesthesia

作　　者：朱广球[1] 杨灵君[1] 尤匡掌[1] 

机构地区：[1]浙江省台州医院麻醉科,浙江临海317000

出　　处：《中国现代应用药学》2013年第11期1239-1242,共4页Chinese Journal of Modern Applied Pharmacy

摘　　要：目的 研究昼夜节律对丙泊酚全麻诱导时麻醉深度的影响。方法 选择白天组（8：00~12：00）和夜间组（22：00~2：00）全麻手术患者各30例,年龄20~45岁,ASAI级,无睡眠障碍。丙泊酚靶控效应室浓度自1.0μg·mL1开始,每次增加0.5μg·mL1直至3.0μg·mL1。静注咪唑安定0.05mg·kg1、芬太尼5μg·kg1、顺式阿曲库铵0.15mg·kg1,3min后行气管插。依次记录靶控输注前（T0）及各效应室浓度平衡2min后（T1：1.0μg·mL1、T2：1.5μg·mL1、T3：2.0·mL-1、T4：2.5μg·mL1、T5：3.0μg·mL1）及插管前（T6）各时点的BIS值、平均动脉压、心率。结果 夜间组患者在T3、T4、T5、T6时其BIS值明显低于白天组患者（P〈0.05）。在诱导期间平均动脉压和心率随麻醉的加深而降低,组间差异均无统计学意义（P〉0.05）。结论 昼夜节律对丙泊酚麻醉深度有明显的影响,相同效应室浓度下夜间镇静程度比白天深。OBJECTIVE To investigate the influence of circadian rhythm on anesthesia depth of propofbl. METHODS Patients undergoing general anesthesia within 8 ： 00-12 ： 00 or 22 ： 00-2 ： 00 were chosen as day group and night group （n=30 each group）. All the patients aged 20-45 years without sleep disorder. Anesthesia was induced with propofol delivered by target controlled infusion（TCI）. The initial effect-site concentration of propofol was set at 1.0 μg.mL^-1, and increased step-by-step with 0.5 μg.mL^-1 after having balanced for 2 rain until reached 3.0 μg.mL^-1. And then patients were injected with midazolum 0.05 mg·kg^-1, fentanyl 5 μg·kg^-1 and cisatracurium 0.15 mg·kg^-1 by intravenous before tracheal intubation. The bispectral index（BIS）, MAP and HR values were recorded before propofol infused（T0）, at each effect-site concentration of propofol （T1： 1.0 μg.mL^-1; To 1.5 μg.mL^-1; T2 2.0 μg.mL^-1; T4：2.5 μg.mL^-1; Ts： 3.0 μg.mL^-1） and before tracheal intubation（T6）. RESULTS The BIS values were significantly lower at T3, T4, T5 and T6 in night group compared with day group（P〈0.05）. The MAP and HR were gradually decreased when induction, but without significant difference between the two groups（P〉0.05）. CONCLUSION Circadian rhythm may have remarkable effect on the depth of propofol anesthesia, and it is more potent when administered at night.

关 键 词：昼夜节律 丙泊酚 麻醉深度 脑电双频指数 

分 类 号：R969[医药卫生—药理学]