【摘要】 目的:观察电针辅助靶控输注丙泊酚脑电双频指数（BIS）和听觉诱发电位指数（AAI）的变化,了解电针对靶控输注丙泊酚时镇静深度的影响。方法:择期全麻患者80例,随机分为对照组（A组）和电针辅助组（B组）,A组不接受电针刺激,B组于麻醉诱导前20 min接受电针刺激至术毕。两组均以4μg/m L的效应室靶浓度靶控输注（T_CI）丙泊酚行麻醉诱导和麻醉维持,意识消失后,静脉推注1μg/kg的瑞芬太尼,置入喉罩。观察并记录两组T_CI前（T₀）、T_CI开始后5 min（T₁）、10 min（T₂）、15min（T₃）各时间点的MAP、HR、BIS、AAI值以及诱导至意识消失时所需时间和丙泊酚用量。结果:与A组相比,B组各时间点BIS值、AAI值均小于A组（P<0.05）,其中BIS值A组为（97±4）、（39±12）、（40±10）、（41±9）,B组为（78±9）、（27±7）、（27±9）、（28±8）,AAI值A组为（97±5）、（16±4）、（17±4）、（16±3）,B组为（77±4）、（10±4）、（11±4）、（10±3）,两组MAP、HR差异无统计学意义（P>0.05）。与T₀比,两组T₁^T₃ BIS值、AAI值以及MAP均明显下降（P<0.05）,HR无明显变化（P>0.05）。意识消失时间A组为（100±14）s,B组为（56±13）s,B组短于A组（P<0.05）。丙泊酚诱导用量A组为（155±8）mg,B组为（122±6）mg,B组小于A组（P<0.05）。结论:针刺辅助丙泊酚靶控输注时,能增加丙泊酚镇静深度,缩短麻醉诱导时间,减少麻醉诱导剂量。更多还原

【Abstract】 Objective To investigate the effect of electro-acupuncture on depth of sedation produced by target-controlled infusion（TCI） of propofol.Methods Eighty patients, of physical status ASA I or II, aged 25⁶5 yr, undergoing general anesthesia, were randomly allocated into two groups: group A（n=40）, in which patients only received propofol TCI, and group B（n=40）, in which patients received propofol TCI combined with electro-acupuncture. For all patients anesthesia was induced and maintained by propofol TCI of which the target effect-site concentration was set at 4 μ g/m L until the end of study. In group B, electro-acupuncture was applied to the acupoints（Neiguan, Zusanli and Sanyingjiao） starting from 20 min before induction of anesthesia until the end of operation. When the patients had no consciousness, a bolus of remifentanil 1 μg/kg was given i.v and then laryngeal mask was inserted. MAP、HR、BIS、AAI were continuously monitored before and during anesthesia, and were recorded at T₀ and T₁、T₂、T₃（ before TCI and 5 min、10 min、15 min after TCI respectively）. The time for loss of consciousness and the consumption of propofol at loss of consciousness were also recorded.Results Compared with group A, values of BIS and AAI in group B were significantly lower（P < 0.05）. Values of BIS at T₀、T₁、T₂、T₃ were（97±4）、（39±12）、（40±10）、（41±9）in group A and（78±9）、（27±7）、（27±9）、（28±8）in group B. Values of AAI at T₀、T₁、T₂、T₃ were（97±5）、（16±4）、（17±4）、（16±3）in group A and（77±4）、（10±4）、（11±4）、（10±3）in group B. There was no significant difference in MAP and HR between the two groups（P > 0.05）.Compared with T0,MAP、values of BIS and AAI at T₁、T₂、T₃ in both groups decreased significantly（P < 0.05） whereas HR had no significant changes（P > 0.05）. Time for loss of consciousness in group B（56±13） s was shorter than that in group A（100±14 s, P < 0.05）. Consumption of propofol at loss of consciousness in group B（122 ± 6） mg was lower than that in group A（155 ± 8 mg, P < 0.05）.Conclusion Electro-acupuncture can enhance the depth of sedation produced by propofol TCI. The time for loss of consciousness is shortened and the consumption of propofol at loss of consciousness decreases when propofol TCI is combined with electro-acupuncture.更多还原