老年患者注射异丙酚的BIS指数与昼夜节律的关系  

Relationship between BIS and circadian rhythm in Eederly patients injected with propofol

作　　者：吴瑶[1] 张伟[1] 羊妍[1] 顾小萍[1] 马正良[1] WU Yao;ZHANG Wei;YANG Yan;GU Xiao-ping;MA Zheng-liang(Department of Anesthesiology,Gulou Hospital,Medical College of Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,江苏南京210008

出　　处：《武警后勤学院学报（医学版）》2021年第4期39-43,共5页Journal of Logistics University of PAP（Medical Sciences）

基　　金：江苏省南京市医学科技发展资金(QRX17137)。

摘　　要：【目的】探究老年患者注射异丙酚的脑电双频指数(bispectral index,BIS)指数与昼夜节律的关系。【方法】选取经过全身麻醉的胃肠手术的老年患者,按照接受手术时间将其平均分为白天组(9:00~18:00)(A组)、夜间1组(21:00~0:00)(B1组)、夜间2组(0:00~3:00)(B2组),所有患者均采取相同的诱导方案,根据BIS调控异丙酚的输注速度,分别记录患者在入室(T0)、插管前(T1)、插管后1 min(T2)、手术结束时(T3)、拔管时(T4)和拔管后5 min(T5)的收缩压、舒张压和心率、BIS值、拔管时间和麻醉恢复时间,并分析BIS指数与昼夜节律的相关性。【结果】A组患者的收缩压、舒张压、心率值、拔管时间和麻醉恢复时间均较B1组和B2组低;B2组患者的收缩压、舒张压、心率值、拔管时间和麻醉恢复时间均较B1组高;A组患者的BIS值较B1组和B2组高;B1组患者的BIS值较B2组高;A组患者与昼夜节律的相关性较小,B1组和B2组患者与昼夜节律的相关性则较大。【结论】老年患者注射异丙酚的BIS指数与昼夜节律存在相关性,夜间手术的全身麻醉中,为提高患者安全性,应注意降低异丙酚的使用量。【Objective】To explore the relationship between bispectral index(BIS)and circadian rhythm in elderly patients with propofol injection.【Methods】Elderly patients undergoing gastrointestinal surgery under general anesthesia were selected.According to the time of operation,the elderly patients were divided into three groups:group A(9:00~18:00),group B1(21:00~0:00),group B2(0:00~3:00).All the patients were taken the same induction scheme.According to the rate of propofol infusion regulated by BIS,systolic blood pressure,diastolic blood pressure and heart rate,BIS value,extubation time and anesthesia recovery time of patients were recorded before entering the room(T0),before intubation(T1),1 minute after intubation(T2),at the end of operation(T3),at extubation(T4)and 5 minutes after extubation(T5),and the correlation between BIS index and circadian rhythm was analyzed.【Results】The systolic blood pressure,diastolic blood pressure,heart rate,extubation time and anesthesia recovery time in group A were lower than those in group B1 and group B2.The systolic blood pressure,diastolic blood pressure,heart rate,extubation time and anesthesia recovery time in group B2 were higher than those in group B1.The BIS value in group A was higher than that in group B1 and group B2.The BIS value in group B1 was higher than that in group B2.The correlation with circadian rhythm in group A was lower,and it was significant in group B1 and group B2.【Conclusion】The BIS of propofol injection in elderly patients is related to circadian rhythm.In the general anesthesia of night operation,attention should be paid to reducing the use of propofol in order to improve the safety of patients.

关 键 词：老年患者 异丙酚 脑电双频指数 昼夜节律 

分 类 号：R614[医药卫生—麻醉学]