艾司洛尔对异丙酚和舒芬太尼靶控麻醉诱导和切皮时BIS的影响

Effect of Esmolol on the Haemodynamics and the Bispectral Index (BIS) during Induction of Anaesthesia and Skin Incision with Target-controlled Infusion (TCI) of Propofol/Sulfentanil

目的观察艾司洛尔对异丙酚和舒芬太尼靶控麻醉诱导和切皮时血流动力学和BIS的影响。方法选择ASAⅠ～Ⅱ级择期手术病人50例,年龄22～61岁,体重57～80kg,随机分为对照组(S组,26例),艾司洛尔组(E组,24例)。设定异丙酚和舒芬太尼血浆靶控浓度分别为3.0μg/mL和0.2ng/mL。E组给予艾司洛尔,单次0.5mg/kg,然后以50μg.kg-1.min-1持续静注。记录入室时,给与舒芬太尼和异丙酚达到Cp浓度时,插管前,插管后l,3,5min和切皮前,切皮后3min收缩压(SBP),心率(HR)和BIS值。结果E组在输注舒芬太尼和艾司洛尔后SBP,HR,BIS无明显变化,与S组相比也无显著性差异。在插管后1,3min和5min,SBP,HR,BIS较插管前有上升趋势,但无显著性差异,与S组相比明显降低(P<0.01)。切皮后SBP,HR,BIS较切皮前变化不明显,和S组相比,有显著性差异(P<0.01)。结论艾司洛尔本身并不影响BIS的变化,但可抑制气管插管反应和BIS的增加。

Objective To study effect ofesmolol on,the haemodynamics and the bispectral index （BIS） during induction of anaesthesia and skin incision with target-controlled infusion （TCI） of propofol/sulfentanil.Methods Fifty Ⅰ～Ⅱ ASA patients aged 22-61yrs weighing 57-80 kg undergoing elective surgery under general anesthesia were enrolled in this study.The patients were randomly divided into two groups： control group（S group,n=24） and esmolol group（E group,n=26）. Sulfentanil and propofol were administered to a plasma concentration of 0.2ng/mL and 3 μg/mL,respectively.The esmolol group was given a bolus ofesmolol 0.5 mg/kg, followed by an infusion of 50μg/kg/min.SBP,heart rate, BIS were recorded at baseline,when plasma concentration of sulfentanil and propofol was 0.2ng/mL and 3 μg/mL, respectively,incubation, 1,3,5 min after incubation and before and 3min after skin incision.Results There are no significant changes in SBP, HR,BIS after infusion ofsulfentanil or esmolol.SBP, HR, BIS were significantly decrease after incubation of 1,3min and 5min and after incision in E group,as compared with S group（P〈0.01）.Conclusion Esmolol can significantly inhibits the change of the haemodynamics and BIS during induction of anaesthesia and skin incision with target-controlled infusion of propofol/sulfentanil.