脑电双频指数监测与靶控输注丙泊酚联合小剂量舒芬太尼在无痛胃肠镜检查麻醉中的应用  

Study on the application of target-controlled infusion of propofol combined with small- dosage sufentanil guided by bispectral index in painless gastrointestinal endoscopy

作　　者：侯海军[1] 柯敬东[1] 刘英[1] 刘缚鲲[1] 田鸣[1] 

机构地区：[1]首都医科大学附属北京友谊医院麻醉科,北京100050

出　　处：《临床和实验医学杂志》2015年第8期683-685,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨运用脑电双频指数(BIS)监测,获取靶控输注(TCI)丙泊酚复合小剂量舒芬太尼对无痛胃肠镜检查麻醉深度的指导意义。方法将300例接受无痛胃肠镜患者随机分为三组:BIS监测TCI丙泊酚复合小剂量舒芬太尼组(A组,n=100)、BIS监测TCI丙泊酚组(B组,n=100)、单纯TCI丙泊酚组(C组,n=100)。根据血流动力学及BIS值调整丙泊酚的靶浓度。观察血压、心率、呼吸的变化,记录手术时间、术中体动次数、苏醒时间、镇静评分、定向力恢复及其术后的不良反应。结果 300例患者麻醉效果满意,术后均恢复良好,其中丙泊酚用量、苏醒时间和定向率恢复时间C组>B组>A组,A组术中呼吸抑制以及体动发生率以及明显低于C组(P<0.01或P<0.05)。三组术中呛咳发生率无显著差异,三组患者均未见术中知晓。结论 BIS监测TCI丙泊酚复合小剂量舒芬太尼用于无痛胃肠镜检查能减少丙泊酚用量,且可以达到合理的麻醉深度,保证术后麻醉快速苏醒。Objective To explore the efficacy of bispectral index（ BIS） monitoring on the depth of anesthesia in patients undergoing painless gastrointestinal endoscopy with target- controlled infusion（ TCI） of propofol combined with small- dosage of sufentanil. Methods A total of 300 patients performed with painless gastrointestinal endoscopy were randomly divided into 3 groups： group A（ TCI of propofol combined with small- dosage of sufentanil guided by BIS）,group B（ TCI of propofol guided by BIS） and group C（ TCI of propofol）. The target concentration was adjusted according to BIS monitoring numerical value and hemodynamic variables. Blood pressure,heart rate（ HR）,respiratory rate（ RR）,operating time,body involuntary movement during operation,postoperative waking time,sedation scores,recovery time of orientation and postoperative complications were analyzed. Results All patients recovered well after operation. In comparison with group A and B,the total dosage of propofol and postoperative waking time as well as recovery time of orientation in group C had obviously been increased. The incidence rates of respiratory depression and body involuntary movement in operation were significantly lower in group A compared with those of group C（ P〈0. 01 or P〈0. 05）. The difference in rate of chocking during the operation showed no statistically significance in these three groups. There was no patient suffered with intraoperative awareness. Conclusion The application of TCI of propofol combined with small- dosage sufentanil guided by BIS in painless gastrointestinal endoscopy can significantly reduce the dosage of propofol,and it can contribute appropriate depth of anesthesia and early recovery.

关 键 词：无痛胃肠镜检查 麻醉深度 脑电双频指数监测 丙泊酚 舒芬太尼 

分 类 号：R614[医药卫生—麻醉学]