临床麻醉学杂志
臨床痳醉學雜誌
림상마취학잡지
THE JOURNAL OF CLINICAL ANESTHESIOLOGY
2010年
12期
1026-1028
,共3页
丙泊酚%预测效应部位浓度%麻醉趋势指数%脑电双频指数%靶控输注
丙泊酚%預測效應部位濃度%痳醉趨勢指數%腦電雙頻指數%靶控輸註
병박분%예측효응부위농도%마취추세지수%뇌전쌍빈지수%파공수주
Propofol%Predicted effect-site concentration%Narcotrend index%Bispectral index%Target-controlled infusion
目的探讨靶控输注（TCI）丙泊酚预测效应部位浓度（EC）值与麻醉趋势指数（NTI）和脑电双频指数（BIS）的关系。方法 ASAⅠ或Ⅱ级拟行腹部手术的患者30例,诱导插管前均TCI丙泊酚镇静,靶浓度从0.5mg/L开始递增,递增梯度为0.5mg/L,每一浓度输注5min,直至OAA/S评分为0,5min后停止。监测并记录患者NTI、麻醉趋势分级（NTS）及BIS。计算5%、50%及95%患者在语言反应消失（LVC）及意识消失（LOC）时的预测EC、BIS和NTI。结果丙泊酚预测EC与BIS和NTI均呈较好的线性关系（r2分别为0.787、0.792）。5%、50%及95%患者出现LVC时的预测EC分别为1.2、1.8和2.5mg/L,BIS分别为78.2、68.2和59.2,NTI分别为73.9、64.9和55.8。5%、50%及95%患者出现LOC时的预测EC分别为1.6、2.6和3.5mg/L,BIS分别为74.6、58.2和41.5,NTI分别为66.2、55.8和45.3。结论 TCI丙泊酚时患者出现LVC及LOC时预测EC总是在一定的范围波动。丙泊酚预测EC与BIS和NTI均呈较好的线性关系。与BIS比较,出现意识状态改变时NTI数值变化范围较小,用于反映麻醉中患者LVC及LOC可能更有效。
目的探討靶控輸註（TCI）丙泊酚預測效應部位濃度（EC）值與痳醉趨勢指數（NTI）和腦電雙頻指數（BIS）的關繫。方法 ASAⅠ或Ⅱ級擬行腹部手術的患者30例,誘導插管前均TCI丙泊酚鎮靜,靶濃度從0.5mg/L開始遞增,遞增梯度為0.5mg/L,每一濃度輸註5min,直至OAA/S評分為0,5min後停止。鑑測併記錄患者NTI、痳醉趨勢分級（NTS）及BIS。計算5%、50%及95%患者在語言反應消失（LVC）及意識消失（LOC）時的預測EC、BIS和NTI。結果丙泊酚預測EC與BIS和NTI均呈較好的線性關繫（r2分彆為0.787、0.792）。5%、50%及95%患者齣現LVC時的預測EC分彆為1.2、1.8和2.5mg/L,BIS分彆為78.2、68.2和59.2,NTI分彆為73.9、64.9和55.8。5%、50%及95%患者齣現LOC時的預測EC分彆為1.6、2.6和3.5mg/L,BIS分彆為74.6、58.2和41.5,NTI分彆為66.2、55.8和45.3。結論 TCI丙泊酚時患者齣現LVC及LOC時預測EC總是在一定的範圍波動。丙泊酚預測EC與BIS和NTI均呈較好的線性關繫。與BIS比較,齣現意識狀態改變時NTI數值變化範圍較小,用于反映痳醉中患者LVC及LOC可能更有效。
목적탐토파공수주（TCI）병박분예측효응부위농도（EC）치여마취추세지수（NTI）화뇌전쌍빈지수（BIS）적관계。방법 ASAⅠ혹Ⅱ급의행복부수술적환자30례,유도삽관전균TCI병박분진정,파농도종0.5mg/L개시체증,체증제도위0.5mg/L,매일농도수주5min,직지OAA/S평분위0,5min후정지。감측병기록환자NTI、마취추세분급（NTS）급BIS。계산5%、50%급95%환자재어언반응소실（LVC）급의식소실（LOC）시적예측EC、BIS화NTI。결과병박분예측EC여BIS화NTI균정교호적선성관계（r2분별위0.787、0.792）。5%、50%급95%환자출현LVC시적예측EC분별위1.2、1.8화2.5mg/L,BIS분별위78.2、68.2화59.2,NTI분별위73.9、64.9화55.8。5%、50%급95%환자출현LOC시적예측EC분별위1.6、2.6화3.5mg/L,BIS분별위74.6、58.2화41.5,NTI분별위66.2、55.8화45.3。결론 TCI병박분시환자출현LVC급LOC시예측EC총시재일정적범위파동。병박분예측EC여BIS화NTI균정교호적선성관계。여BIS비교,출현의식상태개변시NTI수치변화범위교소,용우반영마취중환자LVC급LOC가능경유효。
Objective To explore the relationship between Bispectral index （BIS） values,Narcotrend index （NTI） values and the predicted effect-site concentration （EC）during target-controlled infusion of propofol. Methods In 30 patients during target-controlled infusion of propofol,the propofol infusion was set at an initial EC of 0.5 mg/L and increased by 0.5 mg/L steps every 5 min until 5 min after the modified observer＇s assessment of alertness/sedation scale（OAA/S） values reached zero. The predicted EC of propofol,the values of NTI,NTS and BIS were recorded,and the sedation level were examined by the modified OAA/S every 20 s. The predicted EC of propofol and the values of BIS and NTI at LVC and LOC in 5%,50% and 95% of patients were calculated. Results There were good linear correlations between BIS,NTI and the predicted EC of propofol （r2=0.787,0.792）.The predicted EC of propofol at LVC in 5%,50% and 95% of patients were 1.2,1.8 and 2.5 mg/L,respectively. The values of BIS and NTI at LVC in 5%,50% and 95% of patients were 78.2,68.2 and 58.2; 73.9,64.9 and 55.8,respectively.The predicted EC of propofol at LOC in 5%,50% and 95% of patients were 1.6,2.6 and 3.5 mg/L,The values of BIS and NTI at LOC in 5%,50% and 95% of patients were 74.6,58.2 and 41.5,66.2,55.8 and 45.3,respectively. Conclusion During target-controlled infusion of propofol,LVC and LOC occurred within a definite range of predicted effect-site concentrations.There were the good linear correlations between BIS,NTI and the predicted EC of propofol.NTI may be more useful than BIS in predicting LVC and LOC because of the smaller range of values for the two clinical end-points.
