| 摘要: |
| 目的：探讨麻醉深度指数(cerebral state index，CSI)监测丙泊酚-瑞芬太尼麻醉患者镇静深度的可行性。方法：44例择期全麻手术患者，ASAⅠ~Ⅱ级，随机分为R0、R2、R4、R6组(n=11)。R0组麻醉诱导时靶控输注(TCI)生理盐水，R2、R4、R6组分别以效应室靶浓度(RCe) 2、4、6 ng/ml TCI瑞芬太尼，输注10 min时开始TCI丙泊酚，初始丙泊酚效应室靶浓度(PCe)均为1.5 μg/ml，每4 min增加0.5 μg/ml，改良警觉/镇静(OAA/S)评分为1分时给予强直刺激，记录在睫毛反射消失、强直刺激反应消失时CSI、脑电双频指数(bispectral index，BIS)、PCe，并对CSI与改良OAA/S评分、BIS、PCe进行直线相关分析。结果：与R0组相比，R2、R4、R6组睫毛反射消失、强直刺激反应消失时CSI、BIS明显升高，PCe明显降低，差异具有统计学意义 (P<0.05或<0.01)。相关性研究结果表明CSI与改良OAA/S评分、BIS呈正相关，与PCe呈负相关(P均<0.01)。结论：CSI可用于监测丙泊酚-瑞芬太尼麻醉患者镇静深度。 |
| 关键词: 麻醉深度指数 丙泊酚 瑞芬太尼 镇静深度 |
| DOI：10.3724/SP.J.1008.2008.00558 |
| 投稿时间：2007-09-06修订日期：2007-12-06 |
| 基金项目: |
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| Cerebral state index for monitoring sedation depth during target-controlled infusion with propofol and remifentanil |
| ZHAO Xiao-hong,LI Jin-bao,DENG Xiao-ming*,XIONG Yuan-chang |
| (Department of Anesthesiology,Changhai Hospital,Second Military Medical University,Shanghai 200433,China) |
| Abstract: |
| Objective：To examine the feasibility of using cerebral state index (CSI) for monitoring the sedation depth during target-controlled infusion (TCI) with propofol and remifentanil．Methods: Forty-four consenting ASA Ⅰ or Ⅱ patients (aged 18-60 years) undergoing elective surgery under general anesthesia were randomly divided into 4 groups (n=11 each) according to the target effect-site concentrations of remifentanil administered by TCI during induction of anesthesia.The target effect-site concentrations of remifentanil of R0,R2,R4,and R6 groups were 0,2 ng·ml-1,4 ng·ml-1,and 6 ng·ml-1,respectively.Anesthesia was induced by TCI with remifentanil and propofol.CSI and bispectral index (BIS) were used to measure the sedation depth.The initial effect-site propofol concentration(PCe) was 1.5 μg·ml-1,which was increased by 0.5 μg·ml-1 every 4 min．The modified OAA/S score (5=alert，1=does not respond to prodding)，loss of eyelash reflex (LOR eyelash) and loss of response to electric tetanic stimulation (LOR tetanic) were compared against CSI,BIS and PCe(calculated effect-site propofol concentration).Correlation coefficients were calculated between CSI and other parameters．Results: The 4 groups were comparable with respect to the ages and bodyweights．CSI and BIS values were higher but PCe value were lower at LOR eyelash and LOR tetanic in R2,R4,and R6 than those in the R0 group ( P<0.05 or 0.01)．CSI was positively correlated with modified OAA/S score and BIS,but negatively with PCe (All P<0.01).Conclusion: CSI can be used for monitoring the depth of sedation produced by TCI with propopo1 and remifentanil. |
| Key words: cerebral state index propofol remifentanil sedation depth |
