摘要
目的:探讨脑状态指数(cerebral state index,CSI)指导下异丙酚复合瑞芬太尼全麻对腹部手术老年患者麻醉恢复和全麻药物用量的影响。方法:腹部择期手术65岁以上患者40例,随机分为A组(CSI组)和B组(对照组),每组20例,A组通过调控异丙酚复合瑞芬太尼泵入速率维持CSI值在适当范围:术中50～60、术毕前约20分钟60～70,B组根据患者血压、心率等临床体征变化来调节麻醉过程中异丙酚复合瑞芬太尼泵入速率,记录两组患者清醒时间,拔管时间,苏醒室留观时间,麻醉药(异丙酚)的用量,以及各时点平均动脉血压(MAP)、心率(HR)、脉搏指氧饱和度(SpO2)及CSI值。结果:在两组患者年龄、性别、体重及手术时间差异无统计学意义(P>0.05)的情况下,A组麻醉药(异丙酚)的用量较B组明显减少(P<0.01),麻醉过程中,与B组比较,A组的CSI值升高(P<0.05),A组清醒时间、拔管时间、苏醒室留观时间较B组明显减短(P<0.01)。结论:CSI指导异丙酚复合瑞芬太尼全麻能减少全麻药的用量并能加快老年患者麻醉恢复。
Objective ：To investigate the effect of cerebral state index （CSI） monitoring during propofol general anesthesia combined with remifentanil on anesthesia recovery profile and requirement in elderly patients undergoing elective intro-abdominal surgery.Methods：Forty ASA II or m patients aged over 65 years undergoing elective intro-abdominal surgery were randomly divided into two groups （n=20 each）：group A （CSI group） and group B （control group） without the limitation of the types of operation. Both groups were induced with midazolam, remifentanil, propofol and rocuronium. Anesthesia were maintained with propofol in micro-pump. In group A protofol infusion rate were adjusted to keep CSI values between 50-60 during operation. The CSI values was increased to 60-70 at 20 min before the end of operation.In group B the depth of anesthesia was maintained based on the clinical experiences of anesthetist. Blood pressure （BP）, heart rate（HR）, saturation of blood oxygen（SpO2） and cerebral state index（CSI） were monitored.The awake time, emergence time, extubation time,anesthesia recovery time,and propofol consumption in two groups were recorded. The follow up study to make sure whether the patients had suffered from awareness and pain was performed.Results：There was no statistic meaning in the age,gender,weight and operation time between the two groups （P〉0.05）. The total amount of protofol consumed was much lower in group A than in group B （P〈 0.01）. The average CSI values were higher in group A than in group B （P〈0.05）,awake time,emergence time,extubation time and anesthesia recovery time were also significantly less than group B（P〈0.01）.Conclusion：Propofol infusion combined with remifentanil using CSI monitoring can reduce the dose of propofol during operation and contribute to faster recovery from anesthesia in elderly patients undergoing elective intro-abdominal surgery.
出处
《现代医药卫生》
2008年第21期3178-3180,共3页
Journal of Modern Medicine & Health
关键词
脑状态指数
老年患者
全麻
麻醉恢复
Cerebral state index
General anesthesia
Elderly patient
Anesthesia recovery
