睫毛反射指导丙泊酚靶控输注用于无痛胃镜的观察

The feasibility of guiding the effect concentration of propofol for gastroscopy anesthesia by eyelash reflex

目的探讨在无痛胃镜的麻醉诱导时,以睫毛反射作为参考指标个体化设定丙泊酚效应室浓度的可行性。方法选择ASAⅠ-Ⅱ拟行胃镜检查患者115例,采用阶梯递增的方法给药确定麻醉诱导所需的丙泊酚最低效应室浓度,并记录睫毛反射消失时丙泊酚效应室浓度,以及脉搏氧饱和度、血压、心率、体动反应、麻醉时间、手术时间和并发症等。结果无痛胃镜麻醉诱导所需丙泊酚效应室浓度与睫毛反射消失时的丙泊酚效应室浓度呈直线相关关系;发生心动过缓2例,用阿托品进行纠正;5例患者出现一过性脉搏氧饱和度下降(85%-90%),吸氧后好转;未发生严重低氧血症、苏醒延迟、低血压等并发症。结论睫毛反射能够作为无痛胃镜麻醉诱导时丙泊酚效应室靶浓度的个体化预先设定的参考指标。

Objective To investigate whether eyelash reflex is feasible as a reference for individually setting the effect compartment concentrations of propofol duing the induction of anesthesia in painless gastroscopy. Methods 115 ASA Ⅰ or Ⅱ patients undergoing endoscopy were observed. The concentration of drug increased step by step so as to determine the minimum effect compartment concentrations of propofol during the anesthesia induction of gastroscopy. The effect compartment concentration of propofol were recorded while the loss of eyelash reflex. The pulse oxygen sat- uration,blood pressure, heart rate, movement in response, anethesia time, operating time and side-effects were moni- tored. Results There was a very good linear correlation between gastroscopy anessthesia and eyelash reflex about the effect compartment concentrations of propofol. Two patients had bradycardia and atropine was used to intreat them. 5 patients developed a transient pulse oxygen saturation decreased（85 - 90%）and improved after oxygen. No complications,such as serious hypoxemia,delayed recovery,hypotension and so on happened. Conclusion Eyelash reflex can be used as a reference to individually preset the target effect concentrations of propofol during the anesthesia induction of gastroscop.