【摘要】 目的以脑电双频谱指数(BIS)60为指标,确定七氟醚全麻诱导半数有效量(ED50)及咪唑安定对其影响。方法全麻患者59例随机分为两组:Ⅰ组(31例)麻醉诱导吸入七氟醚,按序贯法给药;Ⅱ组(28例)七氟醚麻醉诱导前给予咪唑安定0.05mg/kg,同样按序贯法吸入七氟醚。记录患者意识消失时间围插管期MAP、HR、BIS。结果 BIS值达60时,Ⅰ组七氟醚的ED50为3.52%(95%的可信区间为3.46%～3.57%),明显高于Ⅱ组的2.61%(95%的可信区间为2.52%～2.70%)。Ⅰ组插管后MAP、HR显著高于插管前(P<0.01),Ⅱ组插管后循环稳定。Ⅱ组BIS值达60的七氟醚浓度、意识消失时间小于Ⅰ组(P<0.01)。结论七氟醚快速诱导时,BIS值达60插管后血压和心率仍有明显增加。加用咪唑安定有利于减少七氟醚吸入浓度和稳定血流动力学。更多还原

【Abstract】 Objective To determine the median-effective dose(ED50)of sevoflurane induction under bispectral index (BIS) 60 and observe the effect of midazolam on it.Methods Fifty-nine patients of general anesthesia were randomly divided into two groups of Ⅰ induced with sevoflurane inhalation by up-and-down method and Ⅱ given midazolam 0.05 mg/kg before sevoflurane as in groupⅠ.MAP,HR,BIS and the time of losing consciousness were recorded during induction and intubation.Results At BIS 60,the value of ED50 was 3.52% with 95% confidence interval of 3.46%-3.57% in group Ⅰ,which was higher than 2.61% with 95% confidence interval of 2.52%-2.70% in group Ⅱ (P<0.01).MAP and HR were higher after intubation than those before in groupⅠ (P<0.01),which were stable in group Ⅱ with earlier loss of consciousness(P<0.01).ConclusionDuring induction with sevoflurane,MAP and HR are remarkably incresed at BIS 60.Additional use of midazolam before induction is helpful in reducing sevoflurane inhalation and stabilizing circulation during intubation.更多还原