脑电双频谱指数指导下靶控输注依托咪酯效应室浓度模式应用于耳鼻喉短小手术中的效果  

Application of Bispectral Indes Guided Effect-site Concentration of Etomidate Given by Target-controlled Infusion in Minor Otolaryngological Surgery

作　　者：邵路军 SHAO Lujun(Department of Anesthesiology,Zhengzhou BO-AI OPH.and E.N.T.Hospital,Zhengzhou City,He’nan Province 450000)

机构地区：[1]郑州博爱眼耳鼻喉医院麻醉科,河南省郑州市450000

出　　处：《医学理论与实践》2021年第19期3326-3328,3337,共4页The Journal of Medical Theory and Practice

摘　　要：目的:分析脑电双频谱指数(BIS)指导下靶控输注依托咪酯效应室浓度模式应用于耳鼻喉短小手术中的效果。方法:选择医院耳鼻喉科2018年1月-2020年1月进行耳鼻喉短小手术的患者75例。根据麻醉方法不同分为对照组(n=39)和观察组(n=36)。对照组患者接受常规麻醉方法全身麻醉,观察组患者接受BIS指导下靶控输注依托咪酯效应室浓度模式麻醉。比较两组患者生命体征、手术时间、麻醉时间和依托咪酯总用量、血清皮质醇指标、苏醒情况和不良反应。结果:两组插管时、手术开始时和术毕MAP水平较入室前降低,且观察组插管时、手术开始时和术毕MAP水平高于对照组(P<0.05)。两组插管时、手术开始时和术毕HR较入室前降低,但观察组插管时、手术开始时和术毕HR高于对照组(P<0.05)。观察组手术时间、麻醉时间和依托咪酯总用量少于对照组(P<0.05)。两组麻醉前、术后24h和48h血清皮质醇水平较术毕升高,且观察组术毕、术后24h和48h血清皮质醇水平低于对照组(P<0.05),两组麻醉前血清皮质醇水平比较差异无统计学意义(P>0.05)。观察组苏醒时间、拔管时间、定向力恢复时间和不良反应率少于对照组(P<0.05)。结论:BIS指导下靶控输注依托咪酯效应室浓度模式应用于耳鼻喉短小手术能提升麻醉安全性,减少不良反应和麻醉药物使用剂量,促使患者快速康复。Objective:To investigate the application effect of BIS guided effect-site concentration of etomidate given by target-controlled infusion in minor otolaryngological surgery.Methods:75 patients with minor otolaryngological surgery in our hospital from January 2018 to January 2020 were enrolled,and patients were divided into two groups according to different anesthesia methods.Control group(n=39)applied routine general anesthesia,while observation group(n=36)received BIS guided effect-site concentration of etomidate given by target-controlled infusion.The vital signs,operation time,anesthesia time and total dosage of etomidate,serum cortisol indicators,recovery status and adverse reactions were compared between groups.Results:MAP levels at intubation,at the beginning and end of operation were decreased in both groups,and were higher in observation group than in control group(P<0.05).HR at intubation,at the beginning and end of operation was decreased in both groups,and was higher in observation group than in control group(P<0.05).The operation time,anesthesia time and total dosage of etomidate in observation group were less than those in control group(P<0.05).Serum cortisol levels before anesthesia,24 hours and 48 hours after operation were higher than those at the end of operation.Serum cortisol levels at the end of operation,24 hours and 48 hours after operation showed significant difference between groups(P<0.05),while showed no significant difference before anesthesia(P>0.05).The recovery time,extubation time,orientation recovery time and adverse reaction rate were less in observation group than in control group(P<0.05).Conclusion:BIS guided effect-site concentration of etomidate given by target-controlled infusion in minor otolaryngological surgery is safe and effective,which can effectively reduce the adverse reactions and dosage of anesthetics,and promote the recovery.

关 键 词：BIS 靶控输注 依托咪酯 效应室浓度 耳鼻喉短小手术 

分 类 号：R614[医药卫生—麻醉学]