中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2012年
4期
451-453
,共3页
麻醉药,吸入%二异丙酚%脑电描记术%意识丧失%剂量效应关系,药物
痳醉藥,吸入%二異丙酚%腦電描記術%意識喪失%劑量效應關繫,藥物
마취약,흡입%이이병분%뇌전묘기술%의식상실%제량효응관계,약물
Anesthetics,inhalation%Propofol%Electroencephalography%Unconsciousness%Doseresponse relationship,drug
目的 比较七氟烷最低肺泡有效浓度(MAC)和异丙酚意识消失半数有效浓度(EC50)麻醉下患者的脑电双频谱指数(BIS)值.方法 择期手术患者60例,年龄18～60岁,ASA分级Ⅰ或Ⅱ级,体重为标准体重的80％～120％.采用随机数字表法,将患者随机分为七氟烷吸入麻醉组(Sev组)和异丙酚静脉麻醉组(Pro组),每组30例.Sev组采用Datex-Ohmeda麻醉机气体监测仪监测呼气末七氟烷浓度.静脉注射依托咪酯0.3 mg/kg、罗库溴铵1 mg/kg、瑞芬太尼0.2μg/kg诱导气管插管后行机械通气,12.5 min后Pro组TC1异丙酚,设置血浆靶浓度3.8 μg/ml,当效应室浓度达到异丙酚意识消失EC50 (2.2 μg/ml)、1.3 EC50(2.86μg/ml)、1.5 EC50(3.3μg/ml),呼气七氟烷浓度达到1.0 MAC、1.3 MAC、1.5 MAC时记录BIS值、MAP和HR.结果 与Sev组比较,Pro组1.3 MAC或1.3 EC50和1.5 MAC或1.5 EC50时HR升高(P＜0.05),各时点MAP差异无统计学意义(P＞0.05).与1.0 MAC或EC50时比较,2组1.3 MAC或1.3 EC50和1.5 MAC或1.5 EC50时BIS值降低(P＜0.05).组间比较各时点BIS值差异无统计学意义(P＞0.05).结论 七氟烷1.0、1.3、1.5 MAC和异丙酚1.0、1.3、1.5 EC50麻醉下BIS值无差别.
目的 比較七氟烷最低肺泡有效濃度(MAC)和異丙酚意識消失半數有效濃度(EC50)痳醉下患者的腦電雙頻譜指數(BIS)值.方法 擇期手術患者60例,年齡18～60歲,ASA分級Ⅰ或Ⅱ級,體重為標準體重的80％～120％.採用隨機數字錶法,將患者隨機分為七氟烷吸入痳醉組(Sev組)和異丙酚靜脈痳醉組(Pro組),每組30例.Sev組採用Datex-Ohmeda痳醉機氣體鑑測儀鑑測呼氣末七氟烷濃度.靜脈註射依託咪酯0.3 mg/kg、囉庫溴銨1 mg/kg、瑞芬太尼0.2μg/kg誘導氣管插管後行機械通氣,12.5 min後Pro組TC1異丙酚,設置血漿靶濃度3.8 μg/ml,噹效應室濃度達到異丙酚意識消失EC50 (2.2 μg/ml)、1.3 EC50(2.86μg/ml)、1.5 EC50(3.3μg/ml),呼氣七氟烷濃度達到1.0 MAC、1.3 MAC、1.5 MAC時記錄BIS值、MAP和HR.結果 與Sev組比較,Pro組1.3 MAC或1.3 EC50和1.5 MAC或1.5 EC50時HR升高(P＜0.05),各時點MAP差異無統計學意義(P＞0.05).與1.0 MAC或EC50時比較,2組1.3 MAC或1.3 EC50和1.5 MAC或1.5 EC50時BIS值降低(P＜0.05).組間比較各時點BIS值差異無統計學意義(P＞0.05).結論 七氟烷1.0、1.3、1.5 MAC和異丙酚1.0、1.3、1.5 EC50痳醉下BIS值無差彆.
목적 비교칠불완최저폐포유효농도(MAC)화이병분의식소실반수유효농도(EC50)마취하환자적뇌전쌍빈보지수(BIS)치.방법 택기수술환자60례,년령18～60세,ASA분급Ⅰ혹Ⅱ급,체중위표준체중적80％～120％.채용수궤수자표법,장환자수궤분위칠불완흡입마취조(Sev조)화이병분정맥마취조(Pro조),매조30례.Sev조채용Datex-Ohmeda마취궤기체감측의감측호기말칠불완농도.정맥주사의탁미지0.3 mg/kg、라고추안1 mg/kg、서분태니0.2μg/kg유도기관삽관후행궤계통기,12.5 min후Pro조TC1이병분,설치혈장파농도3.8 μg/ml,당효응실농도체도이병분의식소실EC50 (2.2 μg/ml)、1.3 EC50(2.86μg/ml)、1.5 EC50(3.3μg/ml),호기칠불완농도체도1.0 MAC、1.3 MAC、1.5 MAC시기록BIS치、MAP화HR.결과 여Sev조비교,Pro조1.3 MAC혹1.3 EC50화1.5 MAC혹1.5 EC50시HR승고(P＜0.05),각시점MAP차이무통계학의의(P＞0.05).여1.0 MAC혹EC50시비교,2조1.3 MAC혹1.3 EC50화1.5 MAC혹1.5 EC50시BIS치강저(P＜0.05).조간비교각시점BIS치차이무통계학의의(P＞0.05).결론 칠불완1.0、1.3、1.5 MAC화이병분1.0、1.3、1.5 EC50마취하BIS치무차별.
Objective To compare the BIS values in patients under anesthesia with minimum alveolar concentration (MAC) of sevoflurane and median effective concentration (EC50) of propofol at loss of consciousness.Methods Sixty ASA Ⅰ or Ⅱ patients,aged 18-60 yr,undergoing elective surgery under general anesthesia,were equally and randomly divided into 2 groups:inhalational anesthesia with sevoflurane group (group Sev) and intravenous anesthesia with propofol ( group Pro).The end-tidal concentration of sevoflurane was monitored using Aestiva anesthesia machine (Datex Ohmeda) in group Sev.Anesthesia was induced with intravenous injection of etomidate 0.3 mg/kg,rocuronium 1 mg/kg,and remifentanil 0.2 μg/kg.The patients were mechanically ventilated after tracheal intubafion.Sevoflurane inhalation was started 12.5 min after intubation in group Sev.Propofol was given by target-controlled infusion with the target plasma concentration set at 3.8 μg/ml 12.5 min after intubation in group Pro.When the effect-site concentrations of propofol reached EC50 of propofol at loss of consciousness (2.2 μg/ml),1.3 EC50(2.86 μg/ml) and 1.5 EC50 (3.3μg/ml) and when the end-tidal concentrations of sevoflurane reached 1.0,1.3 and 1.5 MAC,BIS value,MAP and HR were recorded.Results HR was significantly higher at 1.3 MAC or 1.3 EC50,and at 1.5 MAC or 1.5 EC50 in group Pro than in group Sev ( P ＜0.05).BIS value was significantly decreased at 1.3 MAC or 1.3 EC50,and at 1.5 MAC or 1.5 EC50 compared with that at 1.0 MAC or EC50(P ＜0.05).There was no significant difference in MAP and BIS value at each time point between the two groups ( P ＞ 0.05).Conclusion No significant change in BIS values is found in patients under anesthesia with 1.0,1.3 and 1.5 MAC of sevoflurane and with 1.0,1.3 and 1.5 EC50 of propofol.
