闭环靶控下不同镇静麻醉深度对肌松药用量的影响

Effect of closed-loop target controlled sedation depth under different dosage of muscle relaxation

目的分析闭环靶控下不同镇静麻醉深度对肌松药用量的影响。方法随机选取我院接收救治的60例ASA I-II级择期行腹腔镜胆囊切除术患者,随机分成观察组和对照组,各30例。两组患者均给予闭环靶控下维持镇静麻醉深度,观察组脑电双频谱字数(BIS)控制在50,对照组BIS控制在60,两组行全麻诱导插管,并给予同等剂量的诱导药,肌松药在同等肌松闭环注射系统条件下进行维持给予,对两组肌松药用量、复苏时间等围术期情况进行回顾性统计学分析。结果观察组麻醉时间、手术时间、复苏时间、拔管时间与对照组相比,数据差异无统计学意义(P均>0.05),观察组术中流血量、输液量、尿量与对照组相比,数据差异无统计学意义(P均>0.05);观察组顺苯阿曲库铵每分钟用量与对照组相比,数据差异无统计学意义(P均>0.05),观察组顺苯阿曲库铵每小时每公斤体质量用量显著低于对照组(P<0.05)。结论闭环靶控下不同镇静麻醉深度对肌松药用量存在一定程度的影响,闭环靶控下静脉麻醉深度较浅时,BIS 60值患者顺苯阿曲库铵用量较大。

Objective To analyze closed-loop target controlled anesthesia under sedation depth on the effects of different pharmaceutically acceptable amount of muscle relaxants. Methods Randomly selected 60 cases of ASA I-II class elective laparoscopic cholecystectomy patients from our hospital to receive treatment and they were randomly divided into observation group and control group, 30 cases in each group. Two groups of patients were given humana closed control to maintain calm under anesthesia depth, observation group of brain electrical double spectrum（BIS） control in 50, the control group were in 60 BIS control, two sets of induction of general anesthesia intubation, and were given the same doses of the drug induced, muscle relaxants were given under the same conditions to maintain muscle relaxant closed loop injection system, the dosage of two groups of muscle relaxant, the recovery time were retrospectively statistical analyzed. Results The anesthesia time, operation time, recovery time, estuation time of the observation group were compared with the control group, the data had no significant difference（P〉0.05）, the amount of bleeding, transfusion volume, urine volume of the patients in the observation group compared with the control group, the data had no significant difference（P 0.05）; observation group with benzene atracurium per minute amount compared with the control group, the data had no significant difference（P〉0.05）, the observation group with benzene atracurium per hour per kg body mass was significantly lower than that of the control group, there were significant difference（P〈0.05）. Conclusion Closed humana control under different dosage of sedation anesthesia depth of muscle relaxant exist a certain degree of influence, closed humana control under intravenous anesthesia depth is shallow, BIS 60 patients need a large amount of benzene.