听觉诱发电位指数与微量氯胺酮-异丙酚联合镇静作用的相关性研究

Correlation Analysis of the Auditory Evoked Potentials Index with the Sedation Induced by Small-dose Ketamine and Propofol

目的:分析听觉诱发电位指数[A-line(r)ARX-index,AAI]与微量氯胺酮和异丙酚联合镇静作用的相关性。方法:30例ASAI- Ⅱ级择期手术成年患者,随机静注异丙酚10 mg·kg-1·h-1(组Ⅰ)、氯胺酮0．05 mg·kg-1+异丙酚10 mg·kg-1·h-1(组Ⅱ)或氯胺酮0．1 mg·kg-1+异丙酚10 mg·kg-1·h-1(组Ⅲ),直至观察者的警觉／镇静评分(OAA／S评分)达到1分。同时使用AAI监测镇静深度。记录分析不同OAA／S评分时的AAI值以及异丙酚持续推注时间(诱导时间)和OAA／S评分1分持续时间(深度镇静时间)。结果: 三组中AAI值与OAA／S评分均显著相关:Spearmans等级相关系数r=0．960、0．941、0．966(P<0．01)。组Ⅱ、组Ⅲ与组Ⅰ相比,异丙酚诱导镇静时间无显著差异,但深度镇静时间显著延长。结论:①微量氯胺酮能延长异丙酚深度镇静时间。②AAI可用于监测两药联合镇静作用。

Objective： To analyze the correlation of the autoregressive model with exogenous input extracted auditory evoked potentials index （A-line ARX-index or AAI） with the sedation induced by small-dose ketamAne and propofol. Methods： Thirty ASAⅠ～Ⅱ adult patients undergoing elective surgery were studied. After having rested for 10 man in the operation room, they were divided into three groups to receive anesthetics until the score level I of the observers assessment of the alertness/ sedation scale （OAA/S） reached, i.e. GroupI（n 10） ： propofol administered at 10mg·kg^-1·h^-1, GroupH （n= 10） ： ketamine 0. 05 mg/kg administered in a bolus, then propofol at 10mg·kg^-1·h^-1 , GroupⅢ （n=10）. ketarnine 0. 1 mg/kg administered in a bolus, then propofol at 10mg·kg^-1·h^-1. AAI was monitored until the score level 2 or more of OAA/S reached. Results： AAI correlated with OAA/S scores significantly in the three groups （the coefficients of Spearman＇s rank correlation r= 0. 960, 0. 941, 0. 966,P〈 0.01 ）. In Group H and Ⅲ, the time from the administration of propofol to OAA/S score 1 was not significantly different from that in Group Ⅰ, however the time OAA/S score 1 lasting for was significantly longer （P 〈 0.01）7. Conclusion：small-dose ketamine can prolong the time of deep sedation induced by propofol, and AAI can be used to monitor the sedation levels when combined using small-dose ketamAne and propofol.