脑电双频指数指导下不同麻醉诱导方式对喉罩插入条件的影响

Effects of different induction methods on laryngeal mask airway inserting condition under the direction of bispectral index

目的观察脑电双频指数(BIS)指导下不同麻醉诱导方式对喉罩插入条件的影响。方法 60例择期行宫腔镜手术患者,ASAⅠ或Ⅱ级,根据诱导方式的不同随机均分为三组:七氟醚复合丙泊酚组(SP组)、七氟醚组(S组)及丙泊酚组(P组)。SP组肺活量法吸入七氟醚,待患者意识消失后静脉注射丙泊酚;S组以肺活量法吸入七氟醚;P组静脉泵注丙泊酚。BIS值稳定于40～50超过20s后插入喉罩。记录诱导开始至成功插入喉罩的时间及成功率;评估下颌松弛度评分和喉罩插入后咳嗽及肢体运动评分。结果诱导至喉罩插入时间S组>SP组>P组(P<0.05)。呼吸暂停发生率P组(40%)明显高于SP和S组(均为0)(P<0.05)。不自主肢体运动发生率P组高于SP和S组(35%vs5%和10%,P<0.05)。结论 BIS指导下七氟醚复合丙泊酚诱导较丙泊酚或七氟醚诱导能提供更好的喉罩插入条件。

Objective To observe the effects of different induction methods on laryngeal mask airway （LMA） inserting condition under the direction of bispectral index （BIS）. Methods Sixty patients scheduled for elective hysteroscopy surgery, ASA class I or Ⅱ, were randomized into three groups （n= 20） ： group SP receiving sevoflurane and propofol induction, group S receiving sevoflurane induction, group P receiving propofol induction. Patients in groups SP and S received ,evoflurane using the vital capacity breath （VCB） technique. The LMA was inserted when BIS mainlined 40-50 over 20 s. The time from the induction to the LMA insertion and the achievement ratio were recorded. The score of jaw mobility, coughing and movement after LMA insertion were assessed and recorded. Results The time from the induction to the LMA insertion was group S〉group SP〉group P （P〈0. 05）. The incidences of apnea and involuntary movement were higher in group P than in groups SP and S （P〈0. 05）. Conclusion Under the direction of BIS, sevoflurane-propofol induction provides better condition for LMA insertion than sevoflurane and propofol.