BIS反馈闭环路靶控输注右美托咪定可减少丙泊酚用量

发布时间：2019-03-31 17:34

【摘要】：目的比较在静脉麻醉中脑电双频指数(BIS)反馈闭环靶控输注(CL-TCI)调控下,右美托咪定(Dex)对丙泊酚用量及对血流动力学的影响。方法需要60例全麻患者参考随机数字表法随机分为D组(n=30)和C组(n=30),D组患者在术前及术中均泵注Dex直至手术结束;C组患者按照同样的方案泵注等量的生理盐水。检测负荷剂量前(T0),负荷剂量后(T1),插管即刻(T2),切皮(T3),手术开始后30 min(T4),缝皮(T5),拔管即刻(T6)的收缩压(SBP)、舒张压(DBP)、心率(HR);BIS值的变化;诱导期及维持期间的丙泊酚的用量。术中及术后出现的血流动力学不良事件。结果在BIS反馈闭环靶控输注调控下,Dex可有效减少麻醉诱导时间,诱导期及维持期丙泊酚的用量,差异具有统计学意义(P0.05)。在拔管即刻,D组的HR,SBP及DBP均较C组减低,差异具有统计学意义(P0.05)。负荷剂量前后D组与C组的BIS值及血流动力学不良反应的发生率差异均无统计学意义(P0.05)。结论 BIS反馈闭环调控下定量证实Dex可减少丙泊酚的用量,同时可减少血流动力学不良反应的发生,不增加麻醉过深的发生率,是较为理想的麻醉辅助药物及镇静药物。
[Abstract]:Aim to compare the effects of right metomidine (Dex) on propofol dosage and hemodynamics under the control of bispectral index (BIS) feedback closed loop target controlled infusion (CL-TCI) during intravenous anesthesia. Methods 60 patients with general anesthesia were randomly divided into two groups: group D (n = 30) and group C (n = 30), D), who received Dex before and during operation until the end of the operation, and group C received the same amount of saline according to the same plan. Systolic blood pressure (SBP),) (DBP), was measured before loading dose (T _ 0), after loading dose (T _ 1), immediately after intubation (T _ 2), skin incision (T _ 3), 30 min (T _ 4), sutured skin (T _ 5), and immediately after extubation (T _ 6). Heart rate (HR); The change of BIS value; the dosage of propofol during induction and maintenance period. Adverse hemodynamic events during and after operation. Results under the control of BIS feedback closed-loop target-controlled infusion, Dex could effectively reduce the induction time of anesthesia, the dosage of propofol during induction period and maintenance period, and the difference was statistically significant (P0.05). At extubation time, HR,SBP and DBP in group D were significantly lower than those in group C (P0.05). There was no significant difference in BIS value and incidence of hemodynamic side effects between group D and group C before and after loading dose (P0.05). Conclusion Dex can reduce the dosage of propofol, reduce the incidence of adverse hemodynamic reactions and not increase the incidence of excessive anesthesia under the closed loop control of BIS feedback. It is an ideal anesthetic adjunct and sedative drug. [WT5 "HZ] [WT5" BZ] [WT5 "BZ]
【作者单位】：南方医科大学南方医院麻醉科;
【分类号】：R614

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