吸烟对冠状动脉旁路移植术麻醉诱导期BIS的影响

Effects of Smoking on Bispectral Index in Coronary Artery Bypass Grafting Patients during Induction of Anesthesia

目的：探讨吸烟对冠状动脉旁路移植术患者麻醉诱导期脑电双频指数（BIS）和血流动力学的影响。方法：选取40例行冠脉搭桥手术患者，ASAⅡ~Ⅲ级，按随机数字表法分为吸烟组20例和未吸烟组20例。所有患者均使用咪唑安定、依托咪酯、异丙酚、舒芬太尼和维库溴铵进行麻醉诱导，记录插管前、插管即刻和插管后1、2、3 min的心率（HR）、平均动脉压（MAP）和BIS值。结果：两组诱导前的基础MAP和BIS的比较差异无统计学意义（P〉0.05）；吸烟组的基础HR慢于未吸烟组。吸烟组气管插管即刻和气管插管后1、2 min的BIS值均高于未吸烟组（P〈0.05）；与未吸烟组相比，吸烟组在气管插管即刻、插管后1、2 min HR和MAP升高更明显（P〈0.05）。结论：吸烟影响冠状动脉旁路移植术麻醉诱导期的BIS，吸烟患者冠状动脉旁路移植手术麻醉诱导期血流动力学变化更加剧烈，更要注意保持血流动力学稳定，有效预防心肌缺血。

Objective：To observe the effects of smoking on bispectral index（BIS）and hemodynamics in coronary artery bypass grafting（CABG） patients during induction of anesthesia. Method：40 patients（ASAⅡ-Ⅲ） for CABG were divided into two groups according to random number table method：smokers（n=20）and non-smokers（n=20）. All patients were using midazolam,etomidate,propofol,sufentanil and vecuronium for induction of anesthesia. Heart rate（HR）,mean arterial pressure（MAP）and BIS were recorded at intubation immediately,before intubation,1min,2 min and 3min after intubation. Result：MAP and BIS before the basis of the two groups comparison differences had no statistical significance（P〉0.05）;The basis of HR in the smoking group was slower than the non-smoking group. Tracheal intubation and tracheal intubation after 1,2 min,BIS values of the smoking group were higher than the non-smoking group（P〈0.05）;Compared with the non-smoking group,during endotracheal intubation and after intubation 1,2 min,HR and MAP of the smoking group were increased more significantly（P〈0.05）.Conclusion：Smoking affects coronary artery bypass grafting anesthesia induction period of the BIS,smoking patients with coronary artery bypass graft surgery anesthesia induction period hemodynamic change is more intense,more attention should be paid to maintain hemodynamic stability,effective prevention of myocardial ischemia.