脑电双频指数闭环反馈控制七氟醚与安氟醚背景量混合用药  

Mixed administration of sevoflurane and basal volume enflurane controlled with bispectral index closed-loop feedback

作　　者：蒲斌[1] 吴琦[2] 

机构地区：[1]新汶矿业集团有限责任公司中心医院麻醉科,山东省新泰市271219 [2]山东大学齐鲁医院麻醉科

出　　处：《中国医药》2014年第8期1217-1220,共4页China Medicine

摘　　要：目的 考察以脑电双频指数闭环反馈控制七氟醚加安氟醚背景量混合用药的麻醉效果及费用.方法 32例70岁以下美国麻醉医师协会Ⅰ～Ⅱ级择控制腹部手术患者自行建立麻醉深度指标脑电双频指数为控制变量的闭环反馈吸入麻醉药用药系统.丙泊酚2 mg/kg、芬太尼4μg/kg、维库溴铵0.1 mg/kg快速静脉诱导后完成气管插管,按手术时间分为S组和M组,S组16例患者用闭环反馈用药系统单独控制七氟醚用药,M组16例患者在1％挥发罐刻度安氟醚的背景用药情况下用闭环反馈用药系统控制七氟醚用药,并在手术结束前30 min停止安氟醚背景用药.用脑电双频指数的执行误差绝对值的中位数和中位绝对偏差分别评估2组控制脑电双频指数的精确度和摆动度,并比较2组患者药物费用.结果 S组与M组患者控制脑电双频指数的精确度分别是6.3±1.5、5.9±1.5,摆动度分别是6.3±1.8、6.2±1.6,2组的精确度和摆动度接近,差异无统计学意义（P＞0.05）.安氟醚背景用药组吸入麻醉药总费用与七氟醚组比较差异有统计学意义[（233 ±26）元比（749 ±98）元,P＜0.01].结论 闭环反馈控制方法可以精确的控制吸入麻醉药混合应用,避免了吸入麻醉药混合应用中常见的麻醉不平稳,合理地吸入麻醉药混合应用可以大幅降低麻醉费用.Objective To determine the performance and cost of a mixed adminstration of bispectral index （BIS） closed-loop feed back controlled sevoflurane with basal volume enflurane.Methods Thirty-two adult patients （American Society of Anesthesiologists Ⅰ-Ⅱ） undergoing elective abdomen surgery were enrolled.Patients were divided into sevoflurane group （n =16） and mixed administration group （n =16）.The BIS monitor and controll software with proportional-integral-differential arithmetic and syringe pump constituted the BIS close-loop feed back administration system.BIS value of 55 was controlled by feedback controlled sevoflurane in both groups after intravenous induction.The fresh gas of anesthesia machine was set at 2 L/min.The enflurane vaporizer opened at 1% scale after intravenous induction and closed half an hour before the end of the opration in the mixed administration group.Results The feedback administration system could controll the BIS around the set point in both groups.The BIS value of the mixed administration group achieved the same precision and stabilization as that of the sevoflurane groups.The consume of sevoflurane in mixed administration group decreased by 76% in sevoflurane group.The inhalation anesthetic cost in mixed administration group and sevoflrane group were significant difference [（233 ±26）yuan vs （749 ±98）yuan,P 〈0.01].Conclusions The appropriate mixed administration of enflurane and sevoflurane can remarkably reduce the cost of inhalation anesthetic.

关 键 词：药物治疗 混合 药物治疗 计算机辅助 麻醉药 吸入/经济学 

分 类 号：R614.2[医药卫生—麻醉学]