饮酒对靶控输注丙泊酚镇静时熵指数影响的临床研究

The clinical research of alcohol influence the entropy during the sedation of propofol by TCI

目的观察与分析饮酒在靶控输注(TCI)丙泊酚镇静时对熵指数变化的影响。方法选择美国麻醉医师学会(ASA)Ⅰ-Ⅱ级、全麻的择期手术患者71例,采用成组设计分为两组:饮酒组(38例)和非饮酒组(33例)。患者均在术前无任何伤害性刺激的情况下,接受单一药物丙泊酚进行镇静,靶血浆药物浓度采用3.5μg/ml。观察并记录两组每分钟的心率(HR)、脉搏血氧饱和度(SpO2)、无创血压(NIBP)、反应熵(RE)、状态熵(SE)、镇静/警觉(OAA/S)评分、靶血浆药物浓度、靶效应室药物浓度及不良事件的发生等指标。结果两组间HR、NIBP、SpO2变化无明显统计学差异(P>0.05)。两组RE在各个OAA/S评分阶段的比较均无统计学差异(P>0.05)。RE、SE与OAA/S评分有很好的相关关系(P<0.01)。结论饮酒患者与非饮酒患者相比,靶控输注丙泊酚镇静时熵指数的变化无明显差异。

Objective To study and analysis the influence of alcohol intake on the change of entropy during sedation of propofol used by TCI（Target-controlled Infusion）.Methods Following the roles of the ASA（American Society of Anesthesiologists）,71 Ⅰ～Ⅱpatients that were scheduled for undergoing elective surgery under general anesthesia were enrolled in this study and were divided into two groups： drinking group（group D,n=38）,non-drinking group（group N,n=33）.They were all sedated by propofol without any other drugs before surgery to avoid interaction,and the target plasma concentration was 3.5 μg/ml.We monitored and recorded NIBP（Non-invasive Blood Pressure）,HR（heart rate）,SPO-2（pulse blood oxygen saturation）,RE（Response Entropy）,SE（state Entropy）,OAA/S（the Modified Observer′s Assessment of Alertness/Sedation） scale,target plasma concentration of propofol,as well as target effect site concentration of propofol in two groups.Results There was no significant difference in HR,NIBP,SpO-2 between two groups（P0.05）.Both RE and SE values correlated well with the OAA/S scale（P0.01）.The changes of RE between different stages of the OAA/S scale were no difference in two groups.Conclusion There was no significant difference in the change of entropy during sedation of propofol used by TCI between two groups.