熵指数监测丙泊酚联合瑞芬太尼静脉全身麻醉患者伤害性刺激强度的可行性评价

Feasibility Evaluation of RE / SE Monitoring on the Stimulus Intensity of Propofol and Remifentanil Intravenous Genernal Anesthesia

目的探讨采用熵指数(RE/SE)监测瑞芬太尼联合丙泊酚实施静脉全身麻醉患者伤害性刺激强度的临床价值。方法选择医院行全身麻醉的择期手术治疗患者50例,分别给予气管插管刺激、80 m A强直电刺激与切皮刺激,对比分析其状态熵(SE)、反应熵(RE)在接受刺激后的变化情况。结果患者接受气管插管刺激、80 m A强直电刺激与切皮刺激后的反应熵分别为(53.9±3.6),(51.9±4.6),(57.5±6.3),较刺激前的(49.2±5.7),(44.3±5.7),(52.1±7.2)明显升高,差异有统计学意义(t=4.92,7.33,3.99,P<0.05);状态熵分别为(55.6±7.3),(58.6±5.5),(58.7±5.3),较刺激前的(47.4±8.2),(41.5±6.1),(51.4±6.3)明显升高,差异有统计学意义(t=5.28,14.72,6.26,P<0.05)。结论采用瑞芬太尼联合丙泊酚对患者实施麻醉后,在接受伤害性刺激的情况下,反应熵、状态熵均有升高,熵指数可作为伤害性刺激强度的反应指标。

Objective To study the clinical value of RE/SE on the stimulus intensity of patients with intravenous general anesthesia with remifentanil and propofol. Methods 50 cases of patients who were treated with general anesthesia were selected and were given intubated stimulation, 80 mA electrical tetanus stimulation and skin incision stimulation respectively. The changes of state entropy （SE） and the response entropy （RE） of the patients receiving stimulation were compared and analyzed. Results After the patients receiving tracheal intubation stimulus, 80 mA electric tetanus stimulation and skin incision stimulation, the RE were （53.9 ±3.6）, （51.9 ±4. 6）, （57.5 ±6.3） respectively, which were significantly higher than （49.2 ±5.7）, （44. 3±5.7）, （52. 1 ±7.2） before stimulation with statis- tically significant difference （ t = 4.92, 7.33, 3.99, P 〈 0.05）. The SE were （55.6 ± 7.3）, （58.6 ±5.5）, （58.7 ± 5.3） respectively, which were significantly higher than （47.4 ± 8.2）, （41.5 ±6. 1）, （51.4 ±6.3） before stimulation with statistically significant difference（t = 5.28, 14.72, 6.26, P 〈 0. 05）. Conclusion After giving remifentanil combined with propofol for anesthesia of patients and resulting in noxious stimulation, the response entropy and state entropy both increase, and the entropy index can be used as the index of the noxious stimulation intensity response.