CAJ | 학술논문

目的评估不同剂量布托啡诺复合丙泊酚诱导对全麻患者脑电双频指数（BIS）及气管插管反应的影响。方法择期全麻手术患者100例,ASAⅠ或Ⅱ级,随机分为五组,每组20例。B30、B40、B50、B60组分别给予布托啡诺30、40、50、60μg/kg,F组给予芬太尼4μg/kg。记录麻醉前3min（T0）、给阿片类药前即刻（T1）、给阿片类药后3min（T2）、插管前即刻（T3）、插管后即刻（T4）、插管后3min（T5）、6min（T6）各时间点血浆靶浓度（Cp）、BIS、HR及MAP。结果与F组比较,B40、B50、B60组在T2～T6时BIS下降明显（P〈0.05）。F组在T2、T3、T5、T6时HR、MAP下降明显;F、B30组在T4时HR、MAP上升明显,而B50、B60组变化不明显。结论布托啡诺复合丙泊酚诱导可进一步降低全麻患者的BIS,对丙泊酚镇静有较强的协同作用,静脉注射40～60μg/kg布托啡诺具有较好的镇静作用,可以较好地抑制气管插管反应。
목적평고불동제량포탁배낙복합병박분유도대전마환자뇌전쌍빈지수（BIS）급기관삽관반응적영향。방법택기전마수술환자100례,ASAⅠ혹Ⅱ급,수궤분위오조,매조20례。B30、B40、B50、B60조분별급여포탁배낙30、40、50、60μg/kg,F조급여분태니4μg/kg。기록마취전3min（T0）、급아편류약전즉각（T1）、급아편류약후3min（T2）、삽관전즉각（T3）、삽관후즉각（T4）、삽관후3min（T5）、6min（T6）각시간점혈장파농도（Cp）、BIS、HR급MAP。결과여F조비교,B40、B50、B60조재T2～T6시BIS하강명현（P〈0.05）。F조재T2、T3、T5、T6시HR、MAP하강명현;F、B30조재T4시HR、MAP상승명현,이B50、B60조변화불명현。결론포탁배낙복합병박분유도가진일보강저전마환자적BIS,대병박분진정유교강적협동작용,정맥주사40～60μg/kg포탁배낙구유교호적진정작용,가이교호지억제기관삽관반응。
Objective To investigate the effect of different doses of butorphanol combined with propofol on BIS values and hemodynamic response to tracheal intubation during induction of anesthesia.Methods One hundred ASA Ⅰ or Ⅱ patients were randomly allocated into 5 groups with 20 patients in each group：30,40,50 and 60 μg/kg of butorphanol was respectively given in groups B30,B40,B50,B60,while in group F 4 μg/kg of fentanyl was infused. The values of Cp,BIS,HR and MAP were recorded 3 min before anesthesia （T0）,before opioids administration （T1）,3 min after opioids administration（T2）,before tracheal intubation（T3）,at the time of intubation（T4）,3 min and 6 min after intubation （T5 and T6）. Results Compared with groups F,BIS value at T2 to T6 decreased significantly in groups B40,B50 and B60. HR and MAP were significant lower in group F at T2 to T6.There were no significant difference in HR and MAP after intubation in groups B50 and B60. Conclusion Butorphanol can further reduce BIS value during propofol anesthesia,indicating the sedative effect of butorphanol. Butorphanol at the doses of 40-60 μg/kg can also inhibit cardiovascular response of tracheal intubation.