CAJ | 학술논문

目的：探讨运用脑电双频指数（ BIS）监测，获取靶控输注（ TCI）丙泊酚复合小剂量舒芬太尼对无痛胃肠镜检查麻醉深度的指导意义。方法将300例接受无痛胃肠镜患者随机分为三组：BIS监测TCI丙泊酚复合小剂量舒芬太尼组（A组，n=100）、BIS监测TCI丙泊酚组（B组，n=100）、单纯TCI丙泊酚组（C组，n=100）。根据血流动力学及BIS值调整丙泊酚的靶浓度。观察血压、心率、呼吸的变化，记录手术时间、术中体动次数、苏醒时间、镇静评分、定向力恢复及其术后的不良反应。结果300例患者麻醉效果满意，术后均恢复良好，其中丙泊酚用量、苏醒时间和定向率恢复时间C组﹥B组﹥A组，A组术中呼吸抑制以及体动发生率以及明显低于C组（ P ﹤0.01或P ﹤0.05）。三组术中呛咳发生率无显著差异，三组患者均未见术中知晓。结论 BIS监测TCI丙泊酚复合小剂量舒芬太尼用于无痛胃肠镜检查能减少丙泊酚用量，且可以达到合理的麻醉深度，保证术后麻醉快速苏醒。
목적：탐토운용뇌전쌍빈지수（ BIS）감측，획취파공수주（ TCI）병박분복합소제량서분태니대무통위장경검사마취심도적지도의의。방법장300례접수무통위장경환자수궤분위삼조：BIS감측TCI병박분복합소제량서분태니조（A조，n=100）、BIS감측TCI병박분조（B조，n=100）、단순TCI병박분조（C조，n=100）。근거혈류동역학급BIS치조정병박분적파농도。관찰혈압、심솔、호흡적변화，기록수술시간、술중체동차수、소성시간、진정평분、정향력회복급기술후적불량반응。결과300례환자마취효과만의，술후균회복량호，기중병박분용량、소성시간화정향솔회복시간C조﹥B조﹥A조，A조술중호흡억제이급체동발생솔이급명현저우C조（ P ﹤0.01혹P ﹤0.05）。삼조술중창해발생솔무현저차이，삼조환자균미견술중지효。결론 BIS감측TCI병박분복합소제량서분태니용우무통위장경검사능감소병박분용량，차가이체도합리적마취심도，보증술후마취쾌속소성。
Objective To explore the efficacy of bispectral index( BIS)monitoring on the depth of anesthesia in patients undergoing painless gastrointestinal endoscopy with target-controlled infusion( TCI)of propofol combined with small-dosage of sufentanil. Methods A to-tal of 300 patients performed with painless gastrointestinal endoscopy were randomly divided into 3 groups:group A( TCI of propofol combined with small-dosage of sufentanil guided by BIS ),group B( TCI of propofol guided by BIS)and group C( TCI of propofol). The target concentration was adjusted according to BIS monitoring numerical value and hemodynamic variables. Blood pressure,heart rate( HR),respiratory rate( RR), operating time,body involuntary movement during operation,postoperative waking time,sedation scores,recovery time of orientation and postoper-ative complications were analyzed. Results All patients recovered well after operation. In comparison with group A and B,the total dosage of propofol and postoperative waking time as well as recovery time of orientation in group C had obviously been increased. The incidence rates of re-spiratory depression and body involuntary movement in operation were significantly lower in group A compared with those of group C( P ﹤0. 01 or P ﹤0. 05). The difference in rate of chocking during the operation showed no statistically significance in these three groups. There was no patient suffered with intraoperative awareness. Conclusion The application of TCI of propofol combined with small-dosage sufentanil guided by BIS in painless gastrointestinal endoscopy can significantly reduce the dosage of propofol,and it can contribute appropriate depth of anesthesia and early recovery.