脑电双频指数反馈调控老年肿瘤患者靶控输注丙泊酚

Clinical study on BIS feedback regulation of elderly tumor patients with target controlled infusion of propofol

目的:探讨脑电双频指数(bispectral index,BIS)反馈调控老年肿瘤患者靶控输注丙泊酚的临床研究。方法:选择2012年10月-2014年10月在我院行胃癌根治术以及直肠癌根治术的128例老年患者,随机分为A组67例、B组61例。A组根据BIS反馈调控靶控输注丙泊酚,而B组根据麻醉医师经验调节丙泊酚输注。记录两组患者入室前(T0)、插管时(T1)、插管后5min(T2)、切皮即刻(T3)、肿瘤切除即刻(T4)、手术结束(T5)时BIS、DBP、SBP、HR变化情况,并计算两组患者丙泊酚用量。结果:在T2、T3、T4时间,B组患者DBP、SBP均显著低于A组(P<0.05)。而术中各时间,两组患者HR变化无显著差异(P>0.05)。在T2、T3、T4、T5时间,B组患者BIS显著低于A组(P<0.05)。A组丙泊酚用量为(704.25±100.42)mg,B组丙泊酚用量为(938.53±125.64)mg,两组丙泊酚用量比较,差异具有统计学意义(P<0.05)。结论:老年肿瘤患者采用麻醉深度指数反馈调控靶控输注丙泊酚,有利于保持患者术中血流动力学的平稳,并且有利于避免麻醉药物的过度使用,是一种安全可行的麻醉监测方式。

Objective： To explore the anesthesia depth index（ BIS） in elderly cancer patients of feedback regulation of target controlled infusion of propofol. Methods： All 128 elderly patients with gastric cancer underwent radical resection and radical resection of rectal cancer,were randomly divided into A group（ 67 cases）,61 cases in group B.A group according to the BIS feedback target controlled infusion of propofol,group B according to the experience of anesthesiologists adjusting propofol infusion. Before into operation room（ T0）,before intubation（ T1）,5min after intubation（ T2）,skin incision（ T3）,tumor resection and immediate（ T4）,the end of operation（ T5）,BIS,DBP,SBP,HR changes,dosage of propofol were observed. Results： At T2,T3,T4,DBP,SBP in group B were significantly lower than those in group A（ P〈0. 05）. Time during the operation in the two groups had no significant difference（ P〈0. 05）. HR changes in T2,T3,T4,T5,in group B BIS was significantly lower than that of A group（ P〈0. 05）. The dosage of propofol in group A was（ 704. 25 ± 100. 42） mg,in group B was（ 938. 53 ± 125. 64） mg（ P〈0. 05）. Conclusion： Elderly patients with anesthesia depth index feedback target controlled infusion of propofol is conducive to maintaining hemodynamics with stable,and helps to avoid excessive use of narcotic drugs,is a safe and feasible anesthesia monitoring.