意识指数监测用于无痛结肠镜检查麻醉中药物应用的指导意义

The instructional significance of monitoring on index of consciousness to the drug application for anaesthetic in the patients checked with painless colonoscopy

目的观察意识指数（IOC）用于无痛结肠镜检查麻醉中药物应用的指导意义。方法 100例ASAⅠ-Ⅱ级接受无痛结肠镜检查的患者,年龄18-65岁,随机分成2组：单纯异丙酚组（A组）与IOC监测异丙酚组（B组）,各50例。A组根据患者意识和血流动力学调整异丙酚用量,B组根据IOC值和血流动力学调整异丙酚用量,检查中维持IOC值40-60。分别记录异丙酚总量、苏醒和应答时间及不良反应情况。结果 2组患者均顺利完成检查,与A组比较,B组的异丙酚总量减少,苏醒和应答时间均缩短（P〈0.05）。B组呼吸抑制、恶心呕吐、心动过缓的不良反应发生率明显低于A组,B组体动发生多于A组,但两组的发生率未见明显统计学差异。结论 IOC监测下异丙酚用于无痛结肠镜检查可以达到更合理的麻醉深度,并减少异丙酚用量,术后恢复快,不良反应少。

Objective To discuss the advantage of index of consciousness （IOC） used in patients undergoing painless colonoscopy. Methods 100 patients aged 18-65 with ASA Ⅰ-Ⅱ were randomly divided into group A （propofol） and group B （propofol with IOC）. Propofol was adjusted by consciousness and hemodynamics in group A,while by IOC and hemodynamics in group B. IOC was controlled at 40~60. The total amount of propofol, the awakening and replying time and adverse reaction were recorded. Results Compared with group A, the total amount of propofol, the awakening and replying time were less or shorter in group B. The occurrence rate of adverse reaction of respiratory depression, nausea and vomiting, bradyrhythmia in group B was lower than group A （P〈0.05）. Involuntary movement was less in group A than group B, but there was no significant difference between two groups （P〉0,05）. Conclusion IOC monitoring can reach a more reasonable anesthesia depth with propofol in painless colonoscopy, it can decrease the dose of propofol and adverse reaction, also recover rapidly.