脑电双频指数反馈调控丙泊酚靶控输注用于妇科手术病人的清醒镇静

Target-controlled infusion of propofol for consciousness sedation by BIS feedback

目的 探讨脑电双频指数 (BIS)作为丙泊酚靶控输注的反馈控制变量用于硬膜外麻醉病人清醒镇静的可行性。方法 4 0例ASAⅠ～Ⅱ级拟在硬膜外麻醉下行妇科手术病人 ,随机分为反馈靶控输注组 (反馈组 )和靶控输注组 (靶控组 ) ,每组 2 0例。BIS作为反馈控制变量设定为 80 ,丙泊酚血浆靶浓度设定为 1 7μg/ml,记录并比较两组间的实时BIS值、术中血压下降、呼吸抑制、术中回忆情况、镇静的满意度以及丙泊酚单位标准化使用剂量。结果 反馈组丙泊酚单位标准化使用剂量明显低于靶控组 (P <0 0 1) ;两组间血压下降、呼吸抑制、术中回忆的发生率及镇静的满意率均无显著性差异 (P >0 0 5 )。结论 BIS作为反馈控制变量用于硬膜外麻醉下妇科手术病人的清醒镇静是可行的 ,具有简单易行、安全有效、节约费用的优点。

Objective To investigate the feasibility of target-controlled infusion (TCI) with propofol for conscious sedation by BIS feedback.Methods Forty female patients, ASA physical status I-Ⅱ, scheduled for genecological surgery under epidural anesthesia, were allocated into one of two groups: Feedback TCI group and TCI group. BIS value was set at 80 in feedback TCI group,and target plasm concentration of propofol was set at 1.7 μg/ml throughout sedation. The accidence of hypotension, apnea, recall during operation and the standardizd unit dose of propofol were recorded and compared between two groups. The real-time BIS was not significantly different between two groups.Results The standardizd unit dose of propofol was statistically lower in Feedback TCI group than that in TCI group (P<0.01).There was no significantly difference in accidence of hypotension and apneabetween two groups.The percentage of satisfied sedation had no difference between two groups (P>0.05).Conclusion BIS used as a feedback controlled variate is feasible in propofol sedation by TCI, which has the advantages of saving drug, safety and good effect.