BIS反馈靶控输注丙泊酚复合瑞芬太尼在无痛人流术中的应用

Application of BIS feedback target controlled infusion with propofol and remifentanyl in painless artificial abortion

目的:探讨BIS反馈TCI丙泊酚复合瑞芬太尼在无痛人流中的应用价值及不良反应。方法:120例接受无痛人流患者,随机分成3组(n=40):单纯TCI丙泊酚组(A组)、BIS监测TCI丙泊酚组(B组)、BIS监测TCI瑞芬太尼复合丙泊酚组(C组)。根据BIS值和血流动力学调整丙泊酚和(或)瑞芬太尼TCI靶浓度。观察血压、心率、呼吸的变化以及手术时间、苏醒时间、镇静评分、定向力恢复、术后视觉模拟评分和不良反应。结果:与A组比较,B、C组丙泊酚总量减少,苏醒和定向恢复时间均缩短,术中体动减少(P<0.05),与B组比较,C组丙泊酚总量减少,苏醒时间缩短(P<0.05),定向恢复时间和体动反应无明显差异(P>0.05)。结论:BIS监测下TCI瑞芬太尼复合丙泊酚用于无痛人流可以达到更合理的麻醉深度,且能减少丙泊酚用量,保证术后麻醉快速苏醒。

Objective To investigate the value and side effects of BIS feedback target controlled infusion （TCI） with propofol and remifentanyl in painless artificial abortion. Methods 120 patients receiving painless artificial abortion were randomly divided into 3 groups, Group A （TCI with propofol）, Group B （TCI with propofol under BIS monltoring）, and Group C （TCI with remifentanyl and propofol under BIS monitoring）. The concentration of propofol or remifentanyl was adjusted by BIS value and hemodynamics. BP, HR, RR, operation duration, recovery time, sedation scores, orientation, postoperative visual analogue scale and side effects were recorded. Results As compared to those in Group A, the total dose of propofol, the time of wake-up and orientation, involuntary movement was less in Group B and C （P 〈 0.05） ; and as compared to those in Group B, the former two index were reduced （P 〈 0.05）, while the latter two had no significant changes in Group C （P 〉 0.05）. Conclusion Under BIS monitoring, the application of TCI with remifentanyl and propofol in painless artificial abortion can reach more reasonable depth of anesthesia, reduce the dose of propofol, and lead to rapid recovery from anesthesia.