浙江大学学报（医学版）
浙江大學學報（醫學版）
절강대학학보（의학판）
JOURNAL OF ZHEJIANG UNIVERSITY MEDICAL SCIENCES
2010年
1期
84-88
,共5页
李慧玲%佘守章%阎焱%祝胜美
李慧玲%佘守章%閻焱%祝勝美
리혜령%사수장%염염%축성미
甲状腺切除术%麻醉%全身%麻醉药%静脉/投药和剂量%美托咪啶/投药和剂量%二异丙酚/投药和剂量%脑电描记术/药物作用%诱发电位%听觉/药物作用%随机对照试验
甲狀腺切除術%痳醉%全身%痳醉藥%靜脈/投藥和劑量%美託咪啶/投藥和劑量%二異丙酚/投藥和劑量%腦電描記術/藥物作用%誘髮電位%聽覺/藥物作用%隨機對照試驗
갑상선절제술%마취%전신%마취약%정맥/투약화제량%미탁미정/투약화제량%이이병분/투약화제량%뇌전묘기술/약물작용%유발전위%은각/약물작용%수궤대조시험
Thyroidectomy%Anesthesia,general%Anesthetics,intravenous/admin%Medetomidine/admin%Propofol/admin%Electroencephalography/drug eff%Evoked potentials,auditory/drug eff%Randomized controlled trial
目的: 研究丙泊酚靶控输注复合雷米芬太尼麻醉期间,右旋美托咪啶(Dex)对脑电双频谱指数(BIS)和听觉诱发电位指数(AAI)的影响.方法:选择拟于全麻下行甲状腺次全切除术的年轻患者30例(ASA Ⅰ～Ⅱ级),诱导方法:以血浆药物浓度为靶目标进行丙泊酚靶控输注,靶浓度(Ct)为4 mg/L,同时静脉泵注雷米芬太尼1 μg/kg,待患者意识消失后静注罗库溴铵0.6 mg/kg,1 min后气管内插管.术中以雷米芬太尼0.2 μg/(kg·min)~(-1) 维持麻醉,定时追加肌松药,调节丙泊酚靶控输注的Ct值,使BIS维持在50±3;维持10 min稳定后将患者随机双盲分为两组:D组(n=15):Dex 0.4 μg/kg,用生理盐水稀释成5 ml静脉泵注(5 min),C组(对照,n=15):生理盐水5 ml,方法同D组.记录20 min内BIS、AAI、MAP、HR.结果:D组静注Dex后BIS由51.4±2.2逐渐下降,20 min时降为42.2±15.7(P<0.05);而AAI给药前15.1±3.3,20 min内没有明显变化;C组对照观察期间BIS、AAI均无明显变化.结论:丙泊酚靶控输注复合雷米芬太尼麻醉稳定后,静注Dex能使BIS进一步下降,而AAI保持不变.
目的: 研究丙泊酚靶控輸註複閤雷米芬太尼痳醉期間,右鏇美託咪啶(Dex)對腦電雙頻譜指數(BIS)和聽覺誘髮電位指數(AAI)的影響.方法:選擇擬于全痳下行甲狀腺次全切除術的年輕患者30例(ASA Ⅰ～Ⅱ級),誘導方法:以血漿藥物濃度為靶目標進行丙泊酚靶控輸註,靶濃度(Ct)為4 mg/L,同時靜脈泵註雷米芬太尼1 μg/kg,待患者意識消失後靜註囉庫溴銨0.6 mg/kg,1 min後氣管內插管.術中以雷米芬太尼0.2 μg/(kg·min)~(-1) 維持痳醉,定時追加肌鬆藥,調節丙泊酚靶控輸註的Ct值,使BIS維持在50±3;維持10 min穩定後將患者隨機雙盲分為兩組:D組(n=15):Dex 0.4 μg/kg,用生理鹽水稀釋成5 ml靜脈泵註(5 min),C組(對照,n=15):生理鹽水5 ml,方法同D組.記錄20 min內BIS、AAI、MAP、HR.結果:D組靜註Dex後BIS由51.4±2.2逐漸下降,20 min時降為42.2±15.7(P<0.05);而AAI給藥前15.1±3.3,20 min內沒有明顯變化;C組對照觀察期間BIS、AAI均無明顯變化.結論:丙泊酚靶控輸註複閤雷米芬太尼痳醉穩定後,靜註Dex能使BIS進一步下降,而AAI保持不變.
목적: 연구병박분파공수주복합뢰미분태니마취기간,우선미탁미정(Dex)대뇌전쌍빈보지수(BIS)화은각유발전위지수(AAI)적영향.방법:선택의우전마하행갑상선차전절제술적년경환자30례(ASA Ⅰ～Ⅱ급),유도방법:이혈장약물농도위파목표진행병박분파공수주,파농도(Ct)위4 mg/L,동시정맥빙주뢰미분태니1 μg/kg,대환자의식소실후정주라고추안0.6 mg/kg,1 min후기관내삽관.술중이뢰미분태니0.2 μg/(kg·min)~(-1) 유지마취,정시추가기송약,조절병박분파공수주적Ct치,사BIS유지재50±3;유지10 min은정후장환자수궤쌍맹분위량조:D조(n=15):Dex 0.4 μg/kg,용생리염수희석성5 ml정맥빙주(5 min),C조(대조,n=15):생리염수5 ml,방법동D조.기록20 min내BIS、AAI、MAP、HR.결과:D조정주Dex후BIS유51.4±2.2축점하강,20 min시강위42.2±15.7(P<0.05);이AAI급약전15.1±3.3,20 min내몰유명현변화;C조대조관찰기간BIS、AAI균무명현변화.결론:병박분파공수주복합뢰미분태니마취은정후,정주Dex능사BIS진일보하강,이AAI보지불변.
Objective: To evaluate the effect of dexmedetomidine (Dex) on bispectral index (BIS) and auditory evoked potential index (AAI) during anesthesia with target controlled infusion (TCI) of propofol and remifentanyl.Methods: Thirty adult patients (ASA I～II) who were scheduled for elective thyroidectomy were monitored with BIS,AAI,ECG,blood pressure,end-tidal CO_(2),and pulse oximeter before and during anesthesia.Anesthesia was induced by TCI with propofol 4 mg/L and remifentanyl 1 μg/kg.After loss of consciousness the patients were intubated after rocuronium 0.6 mg/kg intravenous injection,remifentanyl was then infused at 0.2 μg/(kg·min)~(-1) and propofol infusion (Ct) was titrated to maintain a BIS value at 50±3.At 10 min after stabilization of anesthesia the patients were randomly and double-blindly divided into 2 groups:Group D (n=15) received Dex 0.4 μg/kg iv administered over 5 min and Group C (n=15) received equal volume of normal saline.Values of BIS,AAI,MAP,HR were recorded every 2 min within 20 min after the administration of the drugs. Results: Before anesthesia the BIS index was 90±2 in Group D and 92±2 in Group C,AAI was 81±1 in Group D and 78±1 in Group C.In anesthesia with target controlled infusion of propofol,BIS index showed a significant decrease with the i.v.administration of Dex 0.4 μg/kg,while AAI remained unchanged.In Group C,both of BIS and AAI remained unchanged after saline injection. Conclusion: During propofol and remifentanyl anesthesia,after the administration of Dex,BIS value demonstrates a predominant decrease,whereas AAI shows no changes.
