二异丙酚靶控输注用于老年患者快通道麻醉时BIS与HRV关系的研究

Relationship between BIS and HRV in target controlled infusion of propofol in rapid passage aneathesia old patients

目的研究老年患者丙泊酚(二异丙酚)靶控输注时不同BIS值(脑电双频指数)的HRV(心率变异性)的变化。探讨不同镇静深度与HRV之间的关系。方法选择60岁以上行门诊内窥镜(支气管镜、胃镜、肠镜)检查患者30例,随机分为3组,A组BIS50～60,B组60～70,C组70～80,各组均在麻醉前、麻醉诱导后,术中、术毕监测BIS、HRV及血液动力学指标。结果A组各监测点HRV明显降低(P<0.05),B组仅有轻度下降(P>0.05),C组明显升高(P<0.05)。结论患者镇静深度BIS60～70时,即可明显抑制内窥镜手术刺激所致的HRV变化,是临床较为合适的镇静深度,可显著降低老年患者交感神经活性、交感/迷走神经均衡性和自主神经总张力,利于机体血液动力学稳定。

Objective To research the effects of target controlled infusion of pmpofol on BIS and HRV and discuss the relationship between different sedative depth and HRV. Metheds Thirty patients aged 〉 60 years underwent endoscopy and were randomly divided into 3 groups, （A） BIS 50-60, （B） 60-70 and （C） 70-80. The BIS, HRV and hemodynamics of 3 groups were mornitoted at preinductive point（T0） ,post inductive point（T1 ） ,point during the operation（T2） and point after operation（T3）. Results HRV of all points decreased significantly in group A（ P 〈 0.05 ）, decreased lightly in group B（ P 〉 0.05 ）, increased obviously in group C（P 〈 0.05 ）. Conclusion The changes of HRV produced by stimulation of operation can be inhibited obviously. The depth of BIS 60- 70 is a clincally suitable sedative depth, which may obviously decrease the sympathetic nervous activation, balance between sympatletic and vagus nerves and tight of atonomic nerves of old patients, which is beneficial to the stability of hemodynamics.