依托咪酯对异丙酚静脉麻醉患者注射痛及脑状态指数的影响

Effect of etomidate on injection pain and brain state index in the patients with propofol intravenous anesthesia

目的观察依托咪酯对异丙酚静脉麻醉患者注射痛及脑状态指数的影响。方法选择2019年9~11月门诊胃镜中心择期行无痛胃肠镜检查的患者89例,男女不限,年龄18~65岁,ASAⅠ~Ⅱ级,随机分为实验组(E组,44例)和对照组(N组,45例)。E组静脉注射依托咪酯0.05 mg/kg,N组静脉注射生理盐水2 mL,60 s后都以5 mg/s的速度静脉推注异丙酚,直至患者肌肉松弛睫毛反射消失。观察静脉推注异丙酚20 s内,患者在意识清醒状态下主诉有无注射痛;观察患者的脑状态指数:疼痛指数(Pi)和镇静指数(WLi)。结果两组异丙酚注射痛的发生率,差异有统计学意义(P<0.01)。两组Pi值差异有统计学意义(P<0.05)。结论(1)预给小剂量的依托咪酯可以降低静脉麻醉患者异丙酚注射痛的发生率及Pi值。(2)脑电疼痛指数(Pi)为疼痛的监测和评估提供了一种更为客观的方法。

Objective To observe the effect of etomidate on injection pain and brain state index in patients undergoing propofol intravenous anesthesia.Methods From September to November 2019,89 patients who underwent painless gastroscopy at the outpatient gastroscopy center were selected.They were either male or female,within ages of 18 to 65 years old,and with ASA gradesⅠtoⅡ.They were randomly divided into experimental group(44 cases in group E)and the control group(45 cases in group N).Group E was given intravenous injection of etomidate of 0.05 mg/kg,and group N was given intravenous injection of 2 mL saline.After 60 s,propofol was injected intravenously at a rate of 5 mg/s until the patient's muscle relaxed and eyelash reflex disappeared.Within 20 s of propofol intravenous injection,whether the patients complained of injection pain in the conscious state was observed;The patient's brain state indices:pain index(Pi)and sedation index(WLi)were observed.Results The difference in the incidence rate of propofol injection pain between the two groups was statistically significant(P<0.01).The difference in the Pi value between the two groups was statistically significant(P<0.05).Conclusion(1)Pre-administration of low-dose etomidate can reduce the incidence rate and Pi value of propofol injection pain in the patients undergoing intravenous anesthesia.(2)EEG pain index(Pi)provides a more objective method for pain monitoring and evaluation.