麻醉意识指数指导环泊酚全身麻醉诱导的安全性和有效性  

The safety and effectiveness of anesthesia consciousness index in guiding the induction of general anesthesia with ciprofol

作　　者：任冬青[1] 李霞 李婷 石磊[1] 李瑞丰[1] 阎文军[1] 朱磊 REN Dongqing;LI Xia;LI Ting;SHI Lei;LI Ruifeng;YAN Wenjun;ZHU Lei(Department of Anesthesiology,Gansu Provincial Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃省人民医院麻醉科,甘肃兰州730000

出　　处：《麻醉安全与质控》2025年第1期23-27,共5页Perioperative Safety and Quality Assurance

基　　金：甘肃省麻醉与脑功能临床医学研究中心项目(21JR7RA675);甘肃省人民医院科技创新平台基金项目(ZX-62000001-2021-260)。

摘　　要：目的评价麻醉意识指数(Ai)监测环泊酚全身麻醉诱导的安全性和有效性。方法选取2023年10月至2024年1月在甘肃省人民医院接受气管插管全身麻醉下行非心脏、非神经外科择期手术的住院患者82例,年龄18~60岁,BMI 18~30 kg/m^(2),ASA分级Ⅰ或Ⅱ级;采用随机数字表法将患者分为丙泊酚组(n=41)和环泊酚组(n=41)。麻醉诱导期丙泊酚组给予1.5~2.5 mg/kg丙泊酚、环泊酚组给予0.4 mg/kg环泊酚,其余麻醉诱导药物相同。安全性指标:(1)诱导前(T_(0))、气管插管前(T_(1))、气管插管后1 min(T_(2))、气管插管后3 min(T_(3))、气管插管后5 min(T_(4))平均动脉压(MAP)、心率(HR)的变化;(2)T_(0)、T_(1)、T_(2)、T_(3)、T_(4)时心血管不良事件及并发症(体动、呛咳、流泪);有效性指标:(1)记录麻醉诱导前(t_(0))、麻醉诱导后2 min(t_(1))、麻醉诱导后4 min(t_(2))、麻醉诱导后6 min(t_(3))、麻醉诱导后8 min(t_(4))、麻醉诱导后10 min(t5)、麻醉诱导后15 min(t6)Ai值;(2)全身麻醉诱导成功率。结果两组患者各时间点MAP比较,差异无统计学意义(P>0.05);两组患者HR在T_(4)时间点差异有统计学意义(P<0.05);两组患者T_(1)时间点心血管不良事件收缩性低血压、舒张性低血压比较,差异有统计学意义(P<0.05),两组患者T_(2)时间点心动过速比较,差异有统计学意义(P<0.05),其余各时间点两组比较,差异无统计学意义(P>0.05);两组患者在t_(1)时间点和t6时间点Ai比较,差异有统计学意义(P<0.05),两组麻醉诱导成功率均为100%。结论Ai指导全身麻醉诱导时给予0.4 mg/kg环泊酚是安全有效的,患者耐受性良好,诱导期血流动力学平稳。Objective To evaluate the safety and effectiveness of anesthesia consciousness index(Ai)in monitoring the induction of general anesthesia with ciprofol.Methods A total of 82 inpatients,aged 18-60 years,BMI 18-30 kg/m^(2),ASAⅠorⅡ,receiving non⁃cardiac or non⁃neurosurgical elective surgery under general anesthesia with endotracheal intubation in Gansu Provincial Hospital from October 2023 to January 2024 were randomly divided into propofol group(n=41)and ciprofol group(n=41).During anesthesia induction period,propofol group was given 1.5-2.5 mg/kg propofol,ciprofol group was given 0.4 mg/kg ciprofol,and other anesthesia induction drugs were the same.Safety indicators:(1)changes in mean arterial pressure(MAP)and heart rate(HR)before induction(T_(0)),before endotracheal intubation(T_(1)),1 min after endotracheal intubation(T_(2)),3 min after endotracheal intubation(T_(3)),and 5 min after endotra⁃cheal intubation(T_(4));(2)cardiovascular adverse events and complications(body movement,choking,tearing)at T_(0),T_(1),T_(2),T_(3),T_(4).Effective indicators:(1)Ai were recorded before anesthesia induction(t_(0)),2 min after anesthesia induction(t_(1)),4 min after anesthesia induction(t_(2)),6 min after anesthesia induction(t_(3)),8 min after anesthesia induction(t_(4)),10 min after anesthesia induction(t5),15 min after anesthesia induction(t6);(2)the rate of successful induction of general anesthesia.Results There was no significant difference in MAP between the two groups at each time point(P>0.05).There was a statistically significant difference in heart rate at T_(4) between the two groups(P<0.05).There were statistically significant differences in systolic hypotension and diastolic hypotension between the two groups at T_(1)(P<0.05),and there were statistically significant differences in sinus tachycardia between the two groups at T_(2)(P<0.05).While there was no significant difference in cardiovascular adverse events between the two groups at other time point(P>0.05).There was significant difference in Ai bet

关 键 词：环泊酚 麻醉意识指数 气管插管 安全性 有效性 

分 类 号：R614.2[医药卫生—麻醉学]