【摘要】 目的观察丙泊酚靶控输注(TCI)用于全麻诱导时,脑电双频指数(BIS)值与应激反应的关系。方法30例气管插管全麻下手术患者随机分为三组,每组10例。Ⅰ组BIS值维持在36~45,Ⅱ组46~55,Ⅲ组56~65,分别于麻醉诱导前(T0)、插管即刻(T1)以及插管后1min(T2)、3min(T3)、5min(T4)和10min(T5)记录HR和MAP,同期抽取桡动脉血测定血糖和皮质醇。结果Ⅰ组MAP、HR于T3、T4时持续下降(P<0.05),且T3、T4时MAP低于Ⅲ组(P<0.05);Ⅱ组T4时MAP低于T0时(P<0.05);Ⅲ组血糖和皮质醇水平T2、T3时高于T0时(P<0.05或P<0.01),血糖T2~T4时较Ⅰ组升高(P<0.05或P<0.01),T3、T4时较Ⅱ组升高(P<0.05),T2、T3时皮质醇水平明显高于Ⅰ组和Ⅱ组(P<0.05或P<0.01)。结论丙泊酚TCI用于全麻诱导时,将BIS值控制在46~55,在有效减轻应激反应的同时,能维持血流动力学的相对稳定。更多还原

【Abstract】 Objective To observe the relationship between the bispectral index (BIS) and the stress response during anesthesia induction by target-controlled influsion (TCI) of propofol.MethodsThirty ASA classⅠor Ⅱ patients scheduled for elective abdominal surgery under general anesthesia were randomly divided into three groups with 10 patients each. The BIS values in groupⅠwas kept at 36-45, group Ⅱ 46-55 and group Ⅲ 56-65. HR,MAP,blood glucose and cortisol were measured before induction(T0),during intubation(T1),at 1 min(T2),3 min(T3),5 min(T4)and 10 min(T5) after intubation. Results MAP and HR in group Ⅰ were lower at T3,T4 than those at T0(P<0.05). Compared with groupⅠ,MAP in group Ⅲ was significantly increased at T3,T4(P<0.05). MAP at T4 in group Ⅲ was significant lower than those at T0 ingroupⅡ(P<0.05). The blood glucose and cortisol at T2 and T3 were obviously higher than those at T0 in group Ⅲ(P<0.05 or P<0.01).The blood glucose in group Ⅲ was significantly higher than that in groupⅠat T2-T4(P<0.05 or P<0.01)and in groupⅡat T3 and T4(P<0.05). The cortisol in group Ⅲ was obviously higher than that in groupⅠandⅡat T2 and T3(P<0.05 or P<0.01). Conclusion During anesthesia induction by TCI of propofol,the BIS values between 46 to 55 may attenuate the stress response to tracheal intubation.更多还原