妇科腹腔镜术中应用脑电双频指数对丙泊酚用量的影响

Impact of bispectral index monitoring on propofol consumption in gynecological patients undergoing laparoscopic surgeries

目的观察妇科腹腔镜手术脑电双频指数(BIS)对靶控输注(TCI)丙泊酚用量的影响。方法择期行腹腔镜妇科手术患者40例,随机均分为BIS指导下TCI丙泊酚组(B组)与常规TCI丙泊酚组(T组),均以瑞芬太尼持续输注维持术中镇痛。记录入室后(T_0)、气管插管后(T_1)、切皮时(T_2)、手术开始后0.5 h(T_3)、手术结束时(T_4)的BP、HR、BIS值,同时取动脉血测定血中肾上腺素、去甲肾上腺素和皮质醇的浓度。结果与T组比较,B组丙泊酚用量减少12%(P<0.05);T_2～T_4时T组MAP、BIS值显著低于B组(P<0.05),应激反应两组差异无统计学意义。结论 BIS能有效减少TCI丙泊酚的用量,而对手术应激反应的影响甚微。

Objective To observe the influence of bispectral index（BIS） on the consumption of propofol used by target controlled infusion（TCI）. Methods Forty gynecological patients scheduled to undergo laparoscopic surgeries were randomly divided into BIS guided TCI group （group B） and no BIS guided TCI group （group T）. All patients received remifentanil infusion to maintain the analgesic. Blood pressure and heart rate before anesthesia （T0）, after intubation （T1）, skin incision （T2）, 1/2 h after the beginning of surgery （T3）, and the end of surgery T4 ）were recorded. Meanwhile, epinephrine, norepinephrine and cortisol concentrations were measured. Results Compare with group T, the consumption of propofol in group B reduced by 12~//00 （P^0.05）. Compared with group B, MAP, BIS values reduced significantly in group T during T2-T4 （P〈0. 05）. No significant difference was observed between two groups. Conclusion BIS can reduce propofol consumption, but has no effect on the stress response.