脑电双频指数监测地佐辛联合依托咪酯在老年无痛胃镜检查中的应用  

Application of bispectral index monitoring dezocine plus etomidate for painless gastroscopy in elderly patients

作　　者：安卫平 徐炳欣 高晓华 赵艳 侯铁柱[2] 

机构地区：[1]许昌市中心医院,河南许昌461000 [2]河南省人民医院内镜中心,河南郑州450003

出　　处：《河南医学研究》2015年第6期6-8,共3页Henan Medical Research

基　　金：河南省医学科技攻关计划项目(201303173)

摘　　要：目的观察在脑电双频指数(bispectral index,BIS)监测下地佐辛联合依托咪酯用于老年患者无痛胃镜检查的有效性及安全性。方法将许昌市中心医院行无痛胃镜检查的老年患者154例,随机分为监测组(M组)和对照组(D组),各77例。两组麻醉方法均为静脉注射地佐辛30μg/kg,密切观察5 min后静脉注射依托咪酯0.2 mg/kg。M组用BIS监测麻醉深度,D组依据麻醉医生临床经验判断。记录两组患者检查前、检查中、检查后的平均动脉血压(mean artery pressure,MAP)、心率(heart rate,HR)、血氧饱和度(pulse oxygen saturation,Sp O2)及依托咪酯用量、苏醒时间、定向恢复时间、满意度与不良反应发生率。结果两组检查前、检查中、检查后的MAP、HR、Sp O2差异无统计学意义(P>0.05)。与D组比较,M组患者满意程度高,二组差异有统计学意义(P<0.05)。M组依托咪酯用量小于D组,差异有统计学意义(P<0.05)。M组苏醒时间、不良反应发生率均小于D组,但差异无统计学意义(P>0.05)。结论老年患者行无痛胃镜检查时,应用BIS监测麻醉深度,麻醉药量减少、不良反应发生率低,安全度提高。Objective To observe the efficacy and safety of bispectral index（ BIS）monitoring dezocine plus etomidate for painless gastroscopy in elderly patients. Methods One hundred and fifty-four elder patients in Xuchang Central Hospital un-dergoing painless gastroscopy were randomly divided into monitoring group（ group M）and control group（ group D）,seventy-seven cases in each group. The patients in two group were given dezocine 30μg/kg by intravenous injection,closely observed for 5 minutes,then given etomidate 0. 2 mg/kg by intravenous injection. The depth of anesthesia in group M was monitored by BIS, and was judged according to clinical experience in group D. The MAP,HR,SpO2 at different time points and the dosage of eto-midate,the emergence and directed recovery time from anesthesia,degree of satisfaction,incidence of adverse reactions of two group were recorded. Results The MAP,HR,SpO2 at different time points in two groups had no statistical significance（ P﹥0. 05）. Compared with group D,there was a higher degree of satisfaction in group M,and the difference between two groups was significant（P﹤0. 05）. The dosages of etomidate in group M were less than group D,and the difference between the two groups was significant（ P﹤0. 05）. The emergence,directed recovery time from anesthesia and the incidence of adverse reaction in group M were less than group D,but the difference between the two groups was not statistically significant（ P﹥0. 05）. Conclusion Application of BIS monitoring dezocine plus etomidate anesthetic for painless gastroscopy in elderly patients could reduce the an-esthetic dosage,decrease the incidence of adverse reactions,and improve the safety.

关 键 词：脑电双频指数 地佐辛 依托咪酯 无痛胃镜检查 

分 类 号：R614.2[医药卫生—麻醉学]