听力障碍因素对患者异丙酚镇静效应的影响  

Effects of hearing disorder factors on analgesic efficacy of propofol

作　　者：王宏伟[1] 沈丹[1] 李兰兰[1] 何龙[1] 何晨辉 张卫[1] 艾艳秋[1] 储勤军[1] Wang Hongwei , Shen Dan, Li Lanlan, He Long, He Chenhui, Zhang Wei, Ai Yanqiu, Chu Qinjun(Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Chin)

机构地区：[1]郑州大学第一附属医院麻醉科,450052

出　　处：《中华麻醉学杂志》2018年第1期52-54,共3页Chinese Journal of Anesthesiology

基　　金：河南省医学科技攻关计划项目（201602094）

摘　　要：目的评价听力障碍因素对患者异丙酚镇静效应的影响。 方法患听力障碍拟在全身麻醉下行耳科手术患者95例为试验组（T组），另选听力功能正常拟在全身麻醉下行非耳科手术的患者95例为对照组（C组），ASA分级Ⅰ或Ⅱ级，年龄18～60岁，体重指数20～30 kg/m2。异丙酚起始血浆靶浓度为1.2 μg/ml，当目标浓度达到血浆靶浓度开始，稳定1 min，梯度增加异丙酚0.3 μg/ml，直到睫毛反射消失且对轻拍肩部无反应，记录此时的BIS值（BISLOC）、异丙酚血浆靶浓度和效应室靶浓度、异丙酚用量和意识消失时间。 结果与C组比较，T组BIS基础值、BISLOC差异无统计学意义（P〉0.05），异丙酚血浆靶浓度、效应室靶浓度和用量降低，意识消失时间缩短（P〈0.05）。随着听力障碍程度加重，意识消失时所需要的异丙酚用量逐渐减少（P〈0.05）。 结论听力障碍患者异丙酚镇静效应增强。Objective To evaluate the effects of hearing disorder factors on analgesic efficacy of propofol. Methods Ninety-five patients with hearing disorders, of American Society of Anesthesiologists physical status ⅠorⅡ, aged 18-60 yr, with body mass index of 20-30 kg/m2, scheduled for elective ear surgery, served as test group （group T）. Ninety-five patients with normal hearing function, of Ameri- can Society of Anesthesiologists physical status I or 11 , aged 18-60 yr, with body mass index of 20-30 kg/m2, scheduled for elective non-ear surgery, served as control group （group C）. Propofol was given at the initial target plasma concentration of 1.2 μg/ml. When the target plasma concentration was achieved, 1 min later the concentration was increased in increments of O. 3 μg/ml. When the patients lost eyelash reflex and had no responses to clapping on the shoulder, bispectral index value and target plasma and effect-site concentrations of propofol, consumption of propofol and time for loss of consciousness were recorded. Re- suits Compared with group C, no significant change was found in bispectral index value at baseline or at loss of consciousness （ P 〉 0. 05 ）, the target plasma and effect-site concentrations and consumption of propofol were significantly decreased, and the time for loss of consciousness was shortened in group T （P〈 0. 05）. The consumption of propofol required at loss of consciousness was gradually reduced with the aggra- vated severity of hearing disorders in group T （P〈O. 05）. Conclusion The analgesic efficacy of propofol is enhanced in the patients with hearing disorders.

关 键 词：听力障碍 二异丙酚 清醒镇静 

分 类 号：R614[医药卫生—麻醉学]