年龄对脑电双频指数指导依托咪酯镇静时血压和心率变化的影响

Age-dependent Relationship on the Arterial Pressure and Heart Rate of Etomidate for Hypnosis with the Guidance of Bispectal Index

目的：研究年龄对脑电双频指数（Bispectal index，BIS）指导依托咪酯镇静时血压和心率的变化有无影响，探讨血压和心率的变化能否反映镇静的深度。方法：150例未用术前药的患者，按年龄分为青年组（A组：18～39岁）、中年组（B组：40～64岁）和老年组（C组：65～80岁），每组再分为0．068mg／kg、0．085mg／kg、0．106mg／kg、0．131mg／kg、0．166mg／kg5个剂量组，每个剂量组10人。经静脉注入依托咪酯后，记录BIS值，0AA／S镇静评分，心率和血压，对诱导后（推药后2分钟）BIS值在50～70的患者的血压和心率进行分析。结果：BIS值在50～70时，老年组血压波动较大，青年组血压波动最小，青年组的心率波动较大，中年组的心率波动最小。结论：在BIS值50～70范围内，年龄对血压变化影响显著，随着年龄增加血压波动增大，血压的变化程度可以估计患者的镇静深度。

Objective：To determine the effects of age on the arterial pressure and heart rate of etomidate for hypnosis in Chinese. Methods：One hundred and fifty unpremedicated patients was allocated into one of three age groups, 18- 39yr（A） ,40-64yr（B） ,and 65-80yr（C）respectively. Patients in each group were sedated with etomidate at five predetermined dose 0. 068mg/ kg,0. 085mg/ kg,0. 106mg/ kg , 0.131 mg/ kg and 0. 166mg/ kg. Bispectal index for analysis of etomidate were taken after etomidate administered and estimate the response of patients. The relationship between doses, bispectal index of etomidate and responses to a verbal command were determined. Results：Arterial pressure of all points decreased significantly in group C（P〈0.05）, decreased lightly in group A （P〉 0.05）, while heart rate of all points decreased significantly in group A（P〈0.05）, decreased lightly in group B（P〉 0.05 ）, at levels of BIS 50 - 70. Conclusion： Aging decreases arterial pressure significantly at levels of BIS 50-70. The changes of arterial pressure may predict the sedation level.