不同剂量舒芬太尼在全麻诱导气管插管时对定量药物脑电图α1频段的影响

Effects of Different Doses of Sufentanil on α1-band of Quantitative Pharmaco-electroencephalography during General Anesthesia Induction by Tracheal Intubation

目的比较在全麻诱导气管插管时使用不同剂量的舒芬太尼对定量药物脑电图(QPEEG)α1频段的影响。方法选择择期全麻手术患者40例,随机分为Ⅰ组(舒芬太尼诱导剂量为0.2μg/kg)和Ⅱ组(舒芬太尼诱导剂量为0.3μg/kg),每组20例。2组给予舒芬太尼后,顺序给予丙泊酚2 mg/kg和顺苯磺阿曲库铵0.15 mg/kg行麻醉诱导,分别记录2组患者麻醉诱导前(T0)、诱导后(T1)、插入气管插管后(T2)的心率(HR)、平均动脉压(MAP)和QPEEG,利用功率谱分析技术计算QPEEG的α1频段的功率百分比。结果与T0时刻比较,T1时刻2组患者的HR、MAP和大部分脑区的α1频段百分比均有所下降(P<0.05);T2与T1相比,Ⅰ组的HR、MAP和α1频段百分比均有所上升(P<0.05),Ⅱ组无明显改变(P>0.05)。结论诱导时使用0.3μg/kg的舒芬太尼可以更好地抑制气管插管时出现的心血管反应,并可使QPEEG的α1频段功率百分比趋于稳定,提示QPEEG的α1频段可以作为反映镇静深度的指标。

Objective To compare the effects of different doses of sufentanil on the α1-band of quantitative phannaco-electroencephalography （QPEEG） during the induction of general anesthesia by tracheal intubation （T I）. Methods Forty selected patients under general anesthesia were randomly divided into two groups, with 20 patients per group. Patients in group Ⅰ were administered 0.2 μg/kg sufentanil, whereas patients in group Ⅱ were administered 0.3 μg/kg sufentanil. Subsequently, the patients were administered 2 mg/kg propofol and 0.15 mg/kg cisatmcurium. HR, MAP, and QPEEG were recorded before induction （T0）, after induction （T1）, and after insertion of the cannula （T2）. Using the method of power spectrum analysis, the α1-band power percentage of QPEEG was calcuated. Results In comparison with TO, the values of HR, MAP, and α1-band power percentage in most areas of the brain were both decreased at T1 （P 〈 0.05）. Furthermore, in comparison with T1, the parameters were increased in group Ⅰ at T2 （P 〈 0.05 ）, but no significant changes were observed in group Ⅱ （P 〉 0.05 ）. Conclusion The administration of 0.3μg/kg sufentanil during anesthesia induction can effectively depress the cardiovascniar response to T1 and stabilize the α1-band power per- centage. This suggests that the α1-band power percentage of QPEEG can be an effective means to monitor the depth of sedation.