不同剂量舒芬太尼诱导下气管插管时指光电容积脉搏波的变化

Finger photoplethysmogram during intubation with various doses of sufentail

目的观察不同剂量舒芬太尼全麻诱导下气管插管时指光电容积脉搏波（FPPG）的变化。方法择期行甲状腺或乳腺手术患者120例，年龄20-60岁，随机分为三组，全麻诱导时舒芬太尼用量分别为0．4ug／kg（S1组）、0．6ug／kg（S2组）、0．8ug／kg（S3组）。分别于入室后10min（L）、麻醉诱导前1min（T1）、诱导后3min（T2）、插管前1min（T3）、插管后1min（T4）采集FPPG信号，各时点描记脉搏波形30s，数据进行离线分析。结果与T1时比较，T2、T3时三组指脉搏波波幅（FPPGA）、脉搏波间隔（PBI）明显升高（P〈0．05）；与T3时比较，T4时三组FPPGA、PBI明显降低（P〈0．05）。与S1组比较，T2～T4时S2、S3组FPPGA、PBI明显升高（P〈0．05）；与S2组比较，T2～T4时S3组FPPGA、PBI明显升高（P〈0．05）。结论FPPG的变化为全麻过程中伤害性应激的监测及抗伤害性措施的调控提供有价值的信息。

Objective To observe the finger photoplethysmogram （FPPG） during intubation with various doses of sufentail. Methods A total of 120 ASA I or II patients aging 20-60 years scheduled for elective thyroid or breast operation were randomized into three groups as follows： group S1, S2, and S3, of which doses of sufentanil during anesthesia induction was 0.4, 0.6, and 0.8 ug/kg,respectively. At the following time points： 10 min after entry （T0）, 1 min before induction （T1）, 3 min after induction（T2 ）, 1 min before intubation（T3 ）, and lmin after intubation（T4 ） ,FPPG signals were recorded for 30 s and collected data were applied for offline analysis. Results FPPGA and PBI in all groups significantly increased at T2, T3 compared with T1 （P〈0.05）. FPPGA and PBI in all groups obviously decreased at T4 compared with T3 （P〈0.05）. At T2-T4, FPPGA and PBI in groups S2 and S3 significantly increased compared to group S1（P〈0.05） ; whereas FPPGA and PBI in group S3 significantly increased compared to group S2（P〈0.05）. Conclusion Analyzing of finger photoplethysmography could help to monitor the nociception-antinociception balance under propofol combined remifentanil general anesthesia, as a well reference for the nociceptive monitoring and antinociceptive regulation.