BIS引导异丙酚镇静辅助椎管内麻醉在腹腔镜手术中的应用研究

Propofol target controlled infusion on bis pectral guided sedation assisted intravertebral anesthesia for laparoscopic operation

目的探讨脑电双频指数(BIS)引导异丙酚靶控输注辅助椎管内麻醉行腹腔镜手术的可行性和优越性。方法选择腹腔镜手术患者60例,随机分为A、B组,每组30例。两组患者均行腰-硬联合麻醉并将麻醉平面控制在T6～T8水平,平面固定后先静脉注射芬太尼1μg/kg(10μg/ml)再以异丙酚镇静,A组在BIS监测下靶控输注异丙酚;B组异丙酚静脉注射负荷剂量后持续静脉泵注。观察两组麻醉前后生命体征的变化情况;比较两组异丙酚用量、手术时间、术后苏醒时间、输液量及不良反应发生情况。结果与B组比较,A组患者手术过程生命体征较稳定,无明显波动,不良反应少;异丙酚用量明显减少,术后苏醒较快(P<0.05)。结论 BIS引导异丙酚靶控输注辅助椎管内麻醉行腹腔镜手术可精确调控麻醉深度并降低异丙酚用量,减少不良反应,是一种安全有效的麻醉方法。

Objective To investigate the feasibility and superiority of propofol target controlled infusion on bispectral guided sedation assisted intravertebral anesthesia for laparoscopic operation. Methods Sixty cases undergoing laparoscopic operation were randomly divided into group A （n = 30） and group B （n = 30）.Patients in two groups were all taken combined-spinal epidural anesthesia and the analgesia planes were controlled at between T6 and T8 .Two groups were administrated 1 μg/kg（10 μg/ml） fentanyl before injected propofol.In group A,propofol was target controlled infusion on bispectral guided;in group B,propofol was injected load quantity followed by sustaining intravenous injection. The changes of vital signs at before and end anesthesia were monitored in each group.The total dose of propofol,operation time,the time of postoperative recovery,the volume of infusion and incidence of adverse reaction were compared between the two groups.Results Compared with group B,the vital signs of group A is stablen,adverse reaction was less; the total dose of propofol significantly decreased;the time of postoperative recovery was significantly fasten （ P 0.05）. Conclusion Propofol target controlled infusion on bispectral guided sedation assisted intravertebral anesthesia for la-paroscopic operation has satisfying and safe anesthetic effects,which can regulate depth of anesthesia exact,decrease dosage of propofol and adverse reaction.