依托咪酯靶控输注用于老年患者快通道麻醉时BIS与HRV关系的研究

The Association of BIS and HRV in Target-Controlled Infusion of Etomidate Used in Fast-tracking Anesthesia of the Elderly

目的：研究老年患者依托咪酯靶控输注时不同BIS值（脑电双频指数）的HRV（心率变异性）的变化情况,探讨不同镇静深度与HRV之间的关系。方法：选择65岁以上行门诊胃镜检查患者30例,随机分为3组,A组BIS45-55,B组55-65,C组65-75,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BIS55-65时,即可明显抑制内镜操作刺激所致的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 study the effects of target-controlled infusion of etomidate on BIS and HRV and discuss the relationship between sedation levels and HRV values.Metheds：Thirty patients aged 〉65 years undergoing gastroscopy,were randomly divided into 3 groups BIS（group A） 45-55,（group B） 55-65 and（group C） 65-75.The BIS,HRV and hemodynamics of 3 groups were monitored at preinduction,（T0）,postinduction（T1）,intraoperation（T2） and postoperation（T3）.Results：HRV values decreased significantly in group A（P〈0.05）,decreased slightly in group B（P〉0.05）,increased obviously in group C（P〈0.05）.Conclusion：The changes of HRV incuced by the stimulation of gastroscopy can be inhibited significantly by increase the depth of sedation.BIS value 55-65 is a clinically suitable sedation level for gastroscopy,which may inhibit the sympathetic nervous activation.This is beneficial to the stability of hemodynamics during gastroscopy.