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脑电双频指数用于重度烧伤患者瑞芬太尼复合丙泊酚靶控输注镇静深度的观察
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脑电双频指数用于重度烧伤患者瑞芬太尼复合丙泊酚靶控输注镇静深度的观察
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Journal Article
脑电双频指数用于重度烧伤患者瑞芬太尼复合丙泊酚靶控输注镇静深度的观察
2012
Overview
目的评价应用脑电双频指数（BIS）监测瑞芬太尼复合丙泊酚静脉靶控输注（TCI）重度烧伤患者麻醉深度的可行性及有效性。方法选择重度烧伤择期（〈1周）行焦痂切除术患者80例,年龄18~65岁,ASAⅡ-Ⅲ级,烧伤总体表面积（TBSA）31%~50%或三度烧伤面积11%~20%,随机分为BIS组（A组）和对照组（B组）,每组40例。两组均以瑞芬太尼复合丙泊酚TCI诱导和维持,分别记录患者入室,意识消失,插管后2min,手术前,手术开始后2、15、30min,术毕,呼之睁眼和Aldrete评分9分时的平均动脉压（MAP）、心率（HR）以及术中各时间点药物靶浓度,记录患者从停药至呼之睁眼、Aldrete评分达9分的时间。结果 A组与B组比较,患者麻醉维持过程中的瑞芬太尼靶浓度（2.12±0.35ng/mlvs 2.50±0.21ng/ml）和丙泊酚靶浓度（2.54±0.22μg/ml vs 2.86±0.31μg/ml）均明显降低（P〈0.01）;A组患者在停药后呼之睁眼（7.90±0.58min vs 8.35±0.66min）、Aldrete评分9分的时间（9.15±0.69min vs 11.13±0.96min）均明显减少（P〈0.01）。两组患者从意识消失起,除插管后2min时点,其余术中各时点的MAP均较入室时的基础值明显降低（P〈0.05）;各时点的HR也较基础值明显下降（P〈0.05）。结论 BIS用于重度烧伤患者围术期瑞芬太尼复合丙泊酚TCI麻醉深度监测有助于减少丙泊酚用量,缩短患者恢复清醒时间。
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