不同剂量舒芬太尼诱导对可视喉镜气管插管BIS值的影响

Effects of Different Dose Sufentanil Induced on BIS Value of Video Laryngoscope Tracheal Intubation

目的:研究不同剂量的舒芬太尼诱导对可视喉镜血流动力学及BIS值的影响,探讨舒芬太尼用于可视喉镜气管插管时的适宜剂量。方法:选择鼻内镜手术患者60例,随机分为A、B、C 3组,每组20例。其中,A组(舒芬太尼0.2μg/kg)、B组(舒芬太尼0.4μg/kg)、C组(舒芬太尼2μg/kg)。均使用Shikani行气管插管。监测并分别记录诱导前(T0),意识消失时(T1),气管插管时(T2),插管后第1分钟(T3)、3分钟(T4)的脑电双频指数(BIS值)、血压(MAP)、心率(HR)。结果:与T0比较,诱导后3组BIS值均有所下降,有统计学意义(P<0.05),组间比较各时间点无统计学意义(P>0.05)。T1与T0相比,3组MAP、HR均下降(P<0.05),而组间比较A组下降程度较小,与B、C组比较有统计学意义(P>0.05);与T0比较3组T2、T3、T4时间点MAP、HR无明显差异(P>0.05)。结论:0.2μg/kg舒芬太尼诱导,在应用可视喉镜气管插管期间血流动力学平稳,且BIS值降低能够确保无术中知晓,是临床应用的最宜剂量。

Objective： To study the effects of different doses of sufentanil on hemodynamics induced by video laryngo- scope and BIS, and further to explore the appropriate dosage of sufentanil for video laryngoscope tracheal intubation. Methods： 60 postoperative anorectal patients were randomly divided into 3 groups （group A, B, C, including 20 cases in each group with the group A （0.2 μg/kg）, group B （sufentanil 0.4 μg/kg）, group C （Ventani 2μg/kg）. Shikani was used for endotracheal intubation. Bispectral index （BIS value）, blood pressure （BP）, heart rate （HR） were monitored and recorded before induction （T0）, loss of consciousness （T1）, tracheal intubation （T2）, first min after intubation （T3）, 3 rain （T4）. Result： Compared with TO, the induction after three sets of BIS values were decreased; there was statistically significant difference （P 〈0.05）. There was no statistical significance （P 〉0.05） in the terms of the comparison between groups at each time point . Compared by Tlwith T0, three groups of MAP and HR were decreased ,and there was statistically significant difference （P 〈 0.05） ; and A group less decreased between group comparison, while compared with the B and C group, there was no statistical significance （P 〉 0.05） ; compared with TO and T2, T3, T4 time point in three groups, MAP, HR had no significant difference （P 〉 0.05）. Conclusions ： The most appropriate dose of sufentanil induction is 0.2 g/kg, which makes it successful that during the application of video laryngoscope intubation, the postoperative hemodynamic status was stable, and the BIS value stability can ensure no intraoperative.