基于听觉诱发电位指数低流量吸入麻醉下异氟醚的药效学研究

发布时间：2018-05-28 13:23

本文选题：麻醉 + 吸入　；参考：《福建医科大学》2014年硕士论文

【摘要】：目的研究低流量吸入麻醉对异氟醚药效学的影响，分析低流量吸入麻醉时听觉诱发电位指数与呼气末浓度的相关性，评价AAI监测低流量异氟醚麻醉深度的可行性。方法30例ASA I～II的病人低流量异氟醚吸入麻醉。诱导前、诱导后5min、高流量洗入期1min、3min、5min、7min、9min、12min，，低流量维持期呼气末异氟醚浓度0.8MAC、1.0MAC、1.3MAC时以及以及关闭异氟醚挥发罐后1、3、5、7、9、12、15、20、30min分别记录BP、HR、AAI、呼气末异氟醚浓度（ETI）。结果以AAI为药效学指标所得到的异氟醚药效学参数：ke0为0.276±0.116min-1，EC501.183±0.216%v/v，γ4.268±1.675。高流量洗入平衡期， AAI显著下降与吸入前相比各时间点的水平均有显著性差异（P0.05），AAI与ETI，MAP，HR相关系数分别为0.862、0.345、0.398。在低流量维持期AAI在各肺泡呼气末浓度之间有显著性差异（P0.05）,AAI与呼气末异氟醚浓度，MAP，HR相关系数分别为0.854、0.454、0.395。结论低流量异氟醚吸入麻醉起效快，较平稳；麻醉过程中AAI与异氟醚呼气末浓度有很好的相关性，可作为监测异氟醚低流量吸入麻醉深度的指标。但AAI与MAP，HR无明显相关性，提示AAI作为监测应激反应的指标需要进一步的研究。
[Abstract]:Objective to study the effect of low flow inhalation anesthesia on the pharmacodynamics of isoflurane, to analyze the correlation between auditory evoked potential index and end expiratory concentration during low flow inhalation anesthesia, and to evaluate the feasibility of monitoring the depth of low flow isoflurane anesthesia by AAI. Methods 30 patients with ASA I~II were anesthetized with low flow isoflurane. Before induction, 5 min after induction, 1 min / 3 min / 5 min / 7 min / 9 min / 12 min, 0.8 MAC / 1.0 MAC / 1.3 MAC during low flow maintenance period, and 1 min / 3 C / min after closing the volatilization tank of isoflurane, BPU HRAAI, end expiratory isoflurane concentration and ETI were recorded respectively at 1 min, 3 min, 5 min after induction and 1 min after closing the volatile pot of isoflurane, respectively, and the end expiratory isoflurane concentration (ETI) was measured. Results the pharmacodynamic parameters of isoflurane obtained by AAI were 0.276 卤0.116min-1EC501.183 卤0.216v / v, 纬 4.268 卤1.675. During the equilibrium period of high flow washing, the levels of AAI decreased significantly compared with those before inhalation. The correlation coefficients of P0.05AAI and ETI MAPA HR were 0.862 卤0.345and 0.398respectively. There were significant differences in AAI between different alveolar end-expiratory concentrations during low flow maintenance period. The correlation coefficients between AAI and end-expiratory isoflurane concentrations were 0.854V 0.454V 0.395. Conclusion low flow isoflurane inhalation anesthesia is effective and stable, and AAI has a good correlation with end-expiratory concentration of isoflurane during anesthesia, which can be used as an index to monitor the depth of isoflurane inhalation anesthesia. However, there was no significant correlation between AAI and MAPHR, suggesting that AAI as an indicator of stress response should be further studied.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

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