丙泊酚复合不同剂量舒芬太尼在成人全麻气管插管时对定量药物脑电图δ频段、β频段的影响  

Effects of propofol combined with different doses of sufentanil onδandβband of quantitative pharmaco-electroencephalogram during endotracheal intubation for general anesthesia in adults

作　　者：王立强 杨寅奇 高雅樵 郑秋岳 严志鑫 WANG Li-qiang;YANG Yin-qi;GAO Ya-qiao(Department of Anesthesia,Zhongshan People's Hospital,Zhongshan 528403,China)

机构地区：[1]中山市人民医院麻醉科,528403

出　　处：《中国实用医药》2024年第18期116-119,共4页China Practical Medicine

基　　金：中山市科技局项目(项目编号:2021B036);中山市医学科研项目申请书(项目编号:2019A020127)。

摘　　要：目的研究不同剂量舒芬太尼与丙泊酚复合应用于成人全身麻醉(全麻)气管插管时对定量药物脑电图(QPEEG)不同频段所产生的影响。方法选取60例全麻气管插管下拟行腹部手术的成人患者作为研究对象,引导患者进入手术室后实施常规心电图监测以及QPEEG检测,通过上述检测手段采集患者不同脑区(左右额叶、顶叶以及颞叶)脑电信号并划分多个频段,分别利用苯磺顺阿曲库铵、丙泊酚以及舒芬太尼进行诱导。根据舒芬太尼不同剂量将患者分为Ⅰ组(0.15μg/kg)、Ⅱ组(0.30μg/kg)以及Ⅲ组(0.45μg/kg),各20例。在三组患者均处于麻醉状态时应用意识深度监测仪观察其意识深度,当Narcotrend指数均在40~60的情况下采集三组患者麻醉诱导后气管插管前1 min(G0)、插管后1 min(G1)的QPEEG信号。对比三组全麻诱导期间需使用阿托品药物、升压药物情况及各脑区δ、β频段功率百分比变化。结果Ⅰ组使用阿托品药物占比为5.00%,无使用升压药物的患者;Ⅱ组使用阿托品药物占比为15.00%,使用升压药物占比为10.00%;Ⅲ组使用阿托品药物占比为40.00%,使用升压药物占比为25.00%;Ⅲ组使用阿托品药物及升压药物的占比高于Ⅰ组,差异体现出统计学意义(P<0.05);Ⅱ组与Ⅰ组和Ⅲ组使用阿托品药物及升压药物的占比对比不具有差异性,未体现出统计学意义(P>0.05)。较之于G0,三组G1所有脑区β频段功率百分比均显著增加,差异体现出统计学意义(P<0.05),其中以左额、左右顶、左右颞脑区变化最明显;G1时所有脑区β频段功率百分比三组对比,差异体现出统计学意义(P<0.05),Ⅰ组>Ⅱ组>Ⅲ组,其中最显著的区域为左额、顶脑区。较之于G0,三组G1所有脑区δ频段功率百分比降低,其中最为明显区域为左额、左右顶脑区;G1时左额脑区δ频段功率百分比三组对比,差异体现出统计学意义(P<0.05),Ⅰ组和Ⅱ组<Ⅲ组;其余脑区三组δ�Objective To study the effect of different doses of sufentanil combined with propofol on different frequency bands of quantitative pharmaco-electroencephalography(QPEEG)during endotracheal intubation for general anesthesia in adults.Methods A total of 60 patients who were to undergo abdominal surgery under general anesthesia with endotracheal intubation were selected as the study subjects.After guiding the patient into the operating room,routine electrocardiogram monitoring and QPEEG detection were performed.The electroencephalogram signals in different brain regions(left and right frontal,parietal,and temporal lobes)of the patient were collected and divided into multiple frequency bands by the above detection methods,and the induction was carried out with cisatracurium besilate,propofol and sufentanil respectively.According to different doses of sufentanil,it could be divided into groupⅠ(0.15μg/kg),groupⅡ(0.30μg/kg)and groupⅢ(0.45μg/kg),each with 20 cases.When patients in the three groups were under anesthesia,depth of consciousness monitor was used to observe the depth of consciousness.QPEEG signals were collected 1 min before endotracheal intubation(G0)and 1 min after endotracheal intubation(G1)when the Narcotrend indexes were all in the range of 40-60.The need for atropine and pressor drugs during induction of general anesthesia and the percentage change inδandβband power in each brain region were compared among the three groups.Results In groupⅠ,the percentage of patients using atropine was 5.00%and no patients using antihypertensive drugs;in groupⅡ,the percentage of using atropine was 15.00%and the percentage of using pressor drugs was 10.00%;in groupⅢ,the percentage of using atropine was 40.00%and the percentage of using pressor drugs was 25.00%;The percentage of using atropine and pressor drugs in groupⅢwas higher than that in groupⅠ,and the difference reflected statistical significance(P<0.05).Comparison of the percentage of using atropine and pressor drugs between groupⅠand group�

关 键 词：丙泊酚 舒芬太尼 全身麻醉 气管插管 定量药物脑电图 频段 

分 类 号：R614.2[医药卫生—麻醉学]