CAJ | 학술논문

目的探讨罗库溴铵对维族患者全麻诱导时熵指数的影响.方法择期行全麻手术的维族患者40例,性别不限,年龄20～50岁,体重45～70kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将患者随机分为2组(n=20):生理盐水对照组(NS组)和罗库溴铵组(R组).靶控输注异丙酚,初始血浆靶浓度为2μg/ml,每隔4 min递增0.5μg/ml,直至反应熵(RE)降至45并维持4 min,血浆浓度和效应室浓度平衡时,R组静脉注射罗库溴铵0.6 mg/kg,NS组给予等容量生理盐水,3 min后静脉注射芬太尼3μg/kg诱导气管插管后行机械通气.于麻醉诱导前即刻(T0)、注射罗库溴铵前(T1)、注射后2 min(T2)、气管插管后即刻、1、2和3 min时(T3-6)记录状态熵(SE)和RE,并计算RE-SE差值.结果与NS组相比,R组T3,4时RE值降低,T2-5时RE-SE差值降低(P＜0.05).结论罗库溴铵可降低维族患者全麻诱导时RE值和RE-SE差值的增高幅度,可能影响熵指数监测麻醉深度的准确性.
목적 탐토라고추안대유족환자전마유도시적지수적영향.방법 택기행전마수술적유족환자40례,성별불한,년령20～50세,체중45～70kg,ASA분급Ⅰ혹Ⅱ급,채용수궤수자표법,장환자수궤분위2조(n=20):생리염수대조조(NS조)화라고추안조(R조).파공수주이병분,초시혈장파농도위2μg/ml,매격4 min체증0.5μg/ml,직지반응적(RE)강지45병유지4 min,혈장농도화효응실농도평형시,R조정맥주사라고추안0.6 mg/kg,NS조급여등용량생리염수,3 min후정맥주사분태니3μg/kg유도기관삽관후행궤계통기.우마취유도전즉각(T0)、주사라고추안전(T1)、주사후2 min(T2)、기관삽관후즉각、1、2화3 min시(T3-6)기록상태적(SE)화RE,병계산RE-SE차치.결과 여NS조상비,R조T3,4시RE치강저,T2-5시RE-SE차치강저(P＜0.05).결론 라고추안가강저유족환자전마유도시RE치화RE-SE차치적증고폭도,가능영향적지수감측마취심도적준학성.
Objective To investigate the effect of rocuronium on spectral entropy during induction of general anesthesia in patients of Uygur nstionality. Methods Forty ASA Ⅰ or Ⅱ patients (Uygur nationality) of both sexes, aged 20-50 yr, weighing 45-70 kg, undergoing elective surgery under general anesthesia, were divided into 2 groups ( n = 20 each): normal saline (NS) group and rocuronium group (group R). Anesthesia was induced with target-controlled infusion of propofol. The initial target plasma concentration wan net at 2 μg/ml. The concentration wan then increased by 0.5 μg/ml every 4 min until response entropy (RE) was decreased to 45 and maintained for 4 min. When the plasma concentration was equal to the effect-site concentration, iv rocuronium 0.6 mg/kg was injected in group R, while group NS received the equal volume of NS instead. Fentanyl 3 μg/kg was injected intravenously at 3 min after recuronium administration. The patients were tracheal intubated and mechanically ventilated. State entropy (SE) and RE were recorded immediately before induction (baseline, To), before rocuronium administration (T1), 2 main after rocuronium administration (T2) and at 0, 1, 2 and 3 min after intubation (T3-6). The difference between RE and SE wan calculated. Results The RE value at T3 and T4 and the difference between RE and SE at T2.5 were significantly lower in group R than in group NS ( P ＜ 0.05). Conclusion Rocuronium can decrease the RE value and degree of increase in the difference between RE and SE during induction of general anesthesia in patients of Uygur nationality, which may affect the accuracy of spectral entropy in monitoring the depth of anesthesia.