BIS监测在喉罩麻醉下腹腔镜胆囊切除术中对血流动力学的影响  

Effects of BIS-guided laryngeal mask anesthesia on hemodynamics in laparoscopic cholecystectomy

作　　者：徐夏[1] 喻学海[1] 彭蔚[1] 朱何叶[1] 杜佳楠[1] 虎琳 

机构地区：[1]海南省农垦三亚医院麻醉科,海南三亚572000

出　　处：《哈尔滨医科大学学报》2015年第1期63-65,共3页Journal of Harbin Medical University

基　　金：三亚市医疗卫生科技创新项目(YW1213)

摘　　要：目的比较脑电双频谱指数（bispectral index,BIS）监测在喉罩麻醉下腹腔镜胆囊切除术中对患者血流动力学和应激反应的影响。方法选择ASAⅠ~Ⅱ级,择期腹腔镜胆囊手术患者40例,随机分成两组：对照组（C组）20例患者由麻醉医师按照临床经验用药,BIS指导组（B组）20例在BIS指导下进行操作,两组均行喉罩通气麻醉。记录麻醉前（T1）、喉罩插入后1 min（T2）、术毕（T3）、喉罩拔出后1min（T4）的平均动脉压（MAP）、心率（HR）、血浆皮质醇（cortisol,COR）、血糖（blood glucose,BG）值以及患者的苏醒时间（T5）、离室时间（T6）、丙泊酚以及瑞芬太尼用量。结果与B组比较,C组MAP、HR在T4时点升高;COR、BG在T3、T4时点升高,且差异显著（P〈0.05）。C组苏醒时间和离室时间长于B组,丙泊酚诱导量和用药总量均多于B组,差异有统计学意义（P〈0.05）。结论 BIS监测下喉罩全麻可以明显减少腹腔镜胆囊切除术中丙泊酚用量,避免血流动力学剧烈波动,减轻了应激反应,并且苏醒时间缩短,使全麻更加安全、有效。Objective To study the influence of bispectral index（ BIS） monitoring laryngeal mask anesthesia on hemodynamics and stress reaction in laparoscopic cholecystectomy. Methods Forty patients of ASA gradeⅠorⅡ scheduled for laparoscopic cholecystectomy were randomly divided into two groups： experiment group（ B,n = 20） and control group（ C,n = 20）.Group C were operated according to clinical experience,and group B were operated under the BIS monitoring. All the patients were adopted laryngeal mask airway anesthesia. MAP,HR,plasma cortisol（ COR）,blood glucose（ BG） value and the awakening time of patients,propofol and remifentanyl dosage were observed and recorded before anesthesia（ T1）,1 min after laryngeal mask insertion（ T2）,the end of surgery（ T3）,1 min after laryngeal mask withdrawal（ T4）. Results The MAP and HR in group B were lower than those in group C at T4; The COR and BG in group C were higher than those in group B at T3 and T4（ P 0. 05）. The awakening time in group C was longer than that in group B; the induction and total dosage of propofol in group C were significantly more than those in group B（ P 0. 05）. Conclusion BIS monitoring on laryngeal mask could efficiently inhibit cardiovascular effects and reduce the stress response in laparoscopic cholecystectomy,that also can reduce the dosage of propofol and shorten the awakening time and provid satisfactory anesthesia effects.

关 键 词：喉罩 腹腔镜手术 脑电双频指数 应激反应 血流动力学 

分 类 号：R614.2[医药卫生—麻醉学]