异丙酚不同效应室浓度下皮肤电传导与脑电双频指数的比较

Comparison of skin conductance with bispectral index in different effect-site concentrations of propofol

目的评价异丙酚靶控输注（TCI）时在不同效应室浓度（Ce）下皮肤电传导（SC）与脑电双频指数（BIS）的变化特点。方法择期全麻下行手术患者30例,年龄25～55岁,ASA（Ⅰ～Ⅱ）级,靶控输注异丙酚,设定血浆靶浓度为3μg/mL,在效应室浓度达到3μg/mL后停止靶控;同时记录靶控期间BIS值、SC值、MAP和HR。比较各监测指标在效应室浓度为：0、0.5、1.0、1.5、2.0、2.5和3.0μg/mL时各自的变化差异,以及与Ce的相关性。结果 SC值和BIS随着Ce的增加逐渐变小,MAP和HR无显著性变化;各监测指标与Ce进行相关分析显示,BIS（r=-0.872,P〈0.01）较SC值（r=0.766,P〈0.01）稍高,HR最低（r=0.136,P〈0.05）。当Ce在0-1.5μg/mL时SC与Ce的相关系数（r=-0.852,P〈0.01）较BIS（r=-0.801,P〈0.01）高;当Ce在1.5-3.0μg/mL时,SC与Ce的相关系数（r=-0.791,P〈0.01）较BIS（r=-0.890,P〈0.01）低。结论在异丙酚靶控输注下,BIS与SC较MAP和HR更好的反映了Ce的变化;在Ce为0～1.5μg/mL时,与BIS相比,SC对反映Ce的变化较敏感。

[ Objective ] To evaluate changes of skin conductance （SC） and bispectral index （BIS） during different target effect-site concentrations （Ce） of propofol. [ Methods ] Thirty ASA （ Ⅰ - Ⅱ ） patients aged 25-55 years, were enrolled into this study in general anesthesia for orthopaedics surgery. The exclusion criteria were known contraindications to potential anesthetic drugs, psychoactive medication, neurological disorder or neuropathy and the use of atropine or other anticholinergics in the pre-operative phase. None of the participants received premedication on the day of surgery. BP, ECG, HR and SpO2 were monitored during anesthesia. Anesthesia was induced with target-controlled infusion （TCI） of propofol through the upper extremity venous. Target plasma concentrations （Cp） was defined as 3.0 μg/mL. MAP, HR, BIS and SC values were recorded in the period of time that Ce reached 3.0 μg/mL. Statistical analysis used repeated measurement ANOVA and correlation analysis. [ Results ] With increase of Ce, the val-ue of SC and BIS decreased gradually. The MAP and HR have little change, and they compared the correlation with the Ce, the correlation coefficient of BIS （r =-0.872, P 〈0.01） was higher than SC （r =0.766, P 〈0.01）; HR（r =0.136, P 〈0.05） is the lowest correlation coefficient in them. However, when Ce was less than 1.5μg/mL, the correlation co- efficient of SC （r =-0.852, P 〈0.01） was higher than BIS （r =-0.801, P 〈0.01）, and SC decreased greatly. When Ce was higher than 1.5 μg/mL, the correlation coefficient of SC （r =-0.791, P 〈0.01） was less than BIS （r =-0.890, P 〈 0.01）, and SC decreased slowly, BIS has no such features. [ Conclusion] During TCI of propofol, the value of both SC and BIS continued to reduce with increasing Ce. They reflected better the changes of Ce than MAP and HR. When Ce was less than 1.StLg/mL, compared with BIS, SC had a good sensitivity reflecting change of Ce.