中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2008年
9期
587-590
,共4页
麻醉学%输注泵%脑电描记术%二异丙酚
痳醉學%輸註泵%腦電描記術%二異丙酚
마취학%수주빙%뇌전묘기술%이이병분
Anesthesiology%Infusion pumps%Electroencephalography%Propofol
目的 确定靶控输注(TCI)异丙酚诱发脑电图爆发性抑制所需的血浆靶浓度,以用于围术期脑保护.方法 150例全麻手术患者,性别不限,年龄18～55岁,体重指数＜30;无心肺肝肾疾患,排除可能影响脑电活动的干扰因素.靶控输注异丙酚行全麻诱导,初始血浆靶浓度设定为5.4 μg/ml.连续实时监测患者的脑电图波形和爆发性抑制比率,靶浓度从5.4 μg/ml开始,以0.3 μg/ml为梯度逐渐上升,每一靶浓度维持15 min,直至出现爆发性抑制,记录此时的血浆靶浓度.结果 靶控输注异丙酚诱发脑电图爆发性抑制所需的血浆靶浓度平均为(6.1±0.6)μg/ml,95%可信区间5.99～6.19 μg/ml,男性与女性之间的差异无统计学意义.结论 将异丙酚血浆靶浓度提高至6.2 μg/ml可诱发出脑电图爆发性抑制,有利于术中脑保护.
目的 確定靶控輸註(TCI)異丙酚誘髮腦電圖爆髮性抑製所需的血漿靶濃度,以用于圍術期腦保護.方法 150例全痳手術患者,性彆不限,年齡18～55歲,體重指數＜30;無心肺肝腎疾患,排除可能影響腦電活動的榦擾因素.靶控輸註異丙酚行全痳誘導,初始血漿靶濃度設定為5.4 μg/ml.連續實時鑑測患者的腦電圖波形和爆髮性抑製比率,靶濃度從5.4 μg/ml開始,以0.3 μg/ml為梯度逐漸上升,每一靶濃度維持15 min,直至齣現爆髮性抑製,記錄此時的血漿靶濃度.結果 靶控輸註異丙酚誘髮腦電圖爆髮性抑製所需的血漿靶濃度平均為(6.1±0.6)μg/ml,95%可信區間5.99～6.19 μg/ml,男性與女性之間的差異無統計學意義.結論 將異丙酚血漿靶濃度提高至6.2 μg/ml可誘髮齣腦電圖爆髮性抑製,有利于術中腦保護.
목적 학정파공수주(TCI)이병분유발뇌전도폭발성억제소수적혈장파농도,이용우위술기뇌보호.방법 150례전마수술환자,성별불한,년령18～55세,체중지수＜30;무심폐간신질환,배제가능영향뇌전활동적간우인소.파공수주이병분행전마유도,초시혈장파농도설정위5.4 μg/ml.련속실시감측환자적뇌전도파형화폭발성억제비솔,파농도종5.4 μg/ml개시,이0.3 μg/ml위제도축점상승,매일파농도유지15 min,직지출현폭발성억제,기록차시적혈장파농도.결과 파공수주이병분유발뇌전도폭발성억제소수적혈장파농도평균위(6.1±0.6)μg/ml,95%가신구간5.99～6.19 μg/ml,남성여녀성지간적차이무통계학의의.결론 장이병분혈장파농도제고지6.2 μg/ml가유발출뇌전도폭발성억제,유리우술중뇌보호.
Objective To determine the optimal target plasma concentration of propoibl required to induce EEG burst suppression administered by TCI in order to decrease cerebral metabolic rate and increase tolerance to cerebral ischemia and hypoxia. Methods One hundred and fifty ASA Ⅰ-Ⅱ patients(aged 18-55 vears old,BMI＜30,Mallampati Score Ⅰ-Ⅱ)scheduled for elective surgery undergoing general anesthesia were enrolled in this study.Patients with systemic diseases or other factors effecting the electrical activitv of brain were excluded. ECG,IBP,SpO2,PetCO2,Temperature and EEG(two-channel referential montage system)were continuously monitored during the procedure.Patients were induced with TCI propofol (the target plasma concentration was initially set at 5.4 μg/ml),After induction and intubation,target plasma concentration was increased by 0.3 μg/ml increment and sustained 15 minutes until EEG burst suppression appeared(stable burst suppression waveform and BSR＞50%),and this target concentration was recorded.Results The mean target plasma concentration of propofol with TCI required to induce EEG burst suppression was 6.1±0.6 μg/ml with 95% confidence interval of 5.99-6.19 μg/ml.There was no significant difference between the genders.Conclusions The target plasma concentration of propofol reached 6.2 μg/ml can induce EEG burst suppression,which is better for intraoperative cerebral protection.
