摘要
目的观察艾司洛尔用于丙泊酚麻醉诱导插管时脑电双频指数（BIS）的变化。方法30例ASAⅠ或Ⅱ级患者随机分为两组，对照组静注生理盐水10ml负荷量后静滴生理盐水，用药组艾司洛尔1mg／kg稀释于生理盐水10ml静注后以250μg·kg^-1·min^-1微量泵输入，然后静注丙泊酚2mg／kg，当两组BIS降至40～50时静注芬太尼2μg／kg、阿曲库铵0．5mg／kg行经口明视气管插管。监测给药前、诱导前、插管前、插管后1、3、5minBIS、MAP及HR，并观察插管后各时点与插管前BIS、MAP、HR的变化差值△BIS、△MAP及△HR。结果插管前对照组及用药组BIS变化差异无显著意义。插管后1、3、5min对照组BIS较插管前显著升高，用药组BIS与插管前比较差异无显著意义，两组间比较差异有显著意义（P〈0．05）。插管后对照组△BIS变化最大百分比为40％，与用药组的6．8％相比差异有极显著意义（P〈0．01）。插管后1、3min对照组MAP、HR显著高于插管前，两组比较差异无显著意义；插管后对照组△MAP及△HR变化最大百分比为55％及40％，明显高于用药组的29％及15％。结论艾司洛尔用于丙泊酚麻醉诱导插管时，对插管前BIS无影响，插管后可抑制B1S的增加。
Objective To investigate the effect of esmolol on bispectral index（BIS）change during induction and orotracheal intubation of propofol anesthesia. Methods Thirty patients were randomly allocated, in a double-blind-fashion, to receive esmolol 1mg/kg followed by 250 μg·kg^-1·min^-1 （esmolol group, n=15） or saline （control group, n=15）. Two minutes latter, the patients received propofol 2 mg/kg. When BIS decreased to 40-50, fentanyl 2 μg/kg and atracurinm 0.5 mg/kg were administrated, and trachea was intubated. BIS was recorded at 10 s interval, mean arterial pres sure（MAP） and heart rate（HR）were measured non-invasively before anesthesia, before induction, before intubation and at 1,3,5 min after intubation. Results There were no significant differences in BIS, MAP or HR between two groups before intubation. BIS increased significantly after intubation compared with the preintubation value in contral group only. The maximum increases of BIS in esmo- lol group and eontrol group were 6.8% and 40%, respectively （P〈0. 01）. The changes in MAP and HR during intubation were also significantly greater in control group than those in esmolol group. Maximum changes in HR and MAP during arotracheal intubation were also significantly greater in control group than those in esmolol group. Conclusion Esmolol does not affect BIS before intubation, but can prevent BIS arousal reactions to tracheal intubation.
出处
《临床麻醉学杂志》
CAS
CSCD
2006年第12期899-901,共3页
Journal of Clinical Anesthesiology
