脑电双频指数指导靶控输注依托咪酯复合瑞芬太尼在宫颈癌手术患者中麻醉效果的临床研究

Anesthesia Effect Analysis on Cervical Cancer Surgery Patients by the Target Control Infusion of Etomidate Combined Remifentanil under the Guide of Bispectral Index

目的探讨脑电双频指数指导靶控输注依托咪酯复合瑞芬太尼在宫颈癌手术患者中应用麻醉效果。方法选择2010年12月至2013年12月深圳市宝安区西乡人民医院收治的90例宫颈癌手术患者,采用随机数字表法将患者分为对照组和观察组,每组45例。常规诱导后,术中维持对照组患者给予丙泊酚复合瑞芬太尼持续泵入,观察组患者给予依托咪酯复合瑞芬太尼持续泵入,观察并记录两组患者的麻醉效果。结果对照组和观察组患者血压变化、心率变化差异无统计学意义(P>0.05),且在平均麻醉诱导时间、平均清醒时间、平均拔管时间、恶心和呕吐发生率方面差异无统计学意义[(3.4±0.5)min比(3.2±0.4)min,(4.9±1.0)min比(5.0±1.0)min,(12.7±1.5)d比(13.2±1.6)d,2.2%(1/45)比4.4%(2/45),2.2%(1/45)比0.0%,均P>0.05]。观察组患者术后躁动和肌肉震颤发生率显著低于对照组患者[8.9%(4/45)比0.0%,13.3%(6/45)比2.2%(1/45),P<0.05]。结论脑电双频指数指导靶控输注依托咪酯复合瑞芬太尼应用于宫颈癌手术患者能收到满意的麻醉效果,具有对心血管影响小和安全高效等特点,非常适合有心血管风险的老年患者。

Objective To investigate the anesthesia effect on the cervical cancer surgery patients by the target control infusion of etomidate combined remifentanil under the guide of bispectral index .Methods A total of 90 cervical cancer surgery patients treated in Shenzhen City Baoan District Xixiang People′s Hospital from Dec.2010 to Dec.2013 were chosen as the research objects.They were divided into control group（n=45 ） and observation group （ n =45 ） by random number table method .Both groups received conventional induction,then the control group was given propofol combined remifentanil by continuous pumping ,while the observation group was given etomidate combined remifentanil ,by continuous pumping,the anesthesia effect of the two groups was observed and recorded.Results There were no statistical difference in the blood pres-sure,heart rate changes（P＆gt;0.05）,and there were no statistical difference in the average anesthesia induc-tion time,average sober time,average extubation time,nausea and vomiting[（3.4±0.5） min vs （3.2 ± 0.4）min,（4.9 ±1.0） min vs（5.0 ±1.0） min,（12.7 ±1.5） d vs（13.2 ±1.6） d,2.2%（1/45） vs 4.4%（2/45）,2.2%（1/45） vs 0.0%,P〉0.05].Incidence of postoperative agitation and muscle tremors in the observation group were less than those of the control group[8.9%（4/45） vs 0.0%,13.3%（6/45） vs 2.2%（1/45）,P〈0.05].Conclusion Anesthesia effect on cervical cancer surgery patients by the tar-get control infusion of etomidate combined remifentanil under the guide of bispectral index is sure ,which has small effect on cardiovascular and is safe and efficient ,thus is very suitable for elderly patients with cardio-vascular risk.