开胸手术异丙酚血药浓度与脑电和心率变异的相关性研究

Correlation between serum concentration of propofol and the electroencephalogram,the heart rate variability during thoracic surgery

目的 探讨异丙酚静脉麻醉血药浓度与脑电和心率变异的相关性。方法 选择 10例开胸手术患者行异丙酚静脉麻醉复合胸段硬膜外阻滞。应用高效液相色谱法测定术中和术后不同时相患者异丙酚的血清浓度 ,记录数量化脑电图和心率变异的变化。结果 在插管、切皮和关胸时脑电BIS和SEF值均显著低于麻醉前 (P <0 0 5或 P <0 0 1)。心率变异Tp值在切皮和关胸时显著低于麻醉前 (P<0 0 1)。术后 15min内脑电BIS值与异丙酚血清浓度呈高度负相关 ,心率变异TP值与异丙酚血清浓度呈中度负相关。结论 BIS可作为判断静脉麻醉深度的指标 ,Tp则为参考指标。

Objective To study the correlation between the serum concentration of propofol and the electroencephalogram,the heart rate variability during thoracic surgery. Methods Ten patients underwent thoracic surgery were chosen to perform thoracic epidural block combined with propofol intravenous anesthesia. The serum concentration of propofol was determined by high-performance liquid chromatography. The quantitative electroencephalogram and heart rate variability was also monitored during and after the operation. Results Bispectral index (BIS) and spectral edge frequency (SEF) scores of EEG at intubation,incision and suture were significantly lower than those of baseline (P<0.05 or P<0.01). Total spectral power (Tp) of ECG at incision and suture were significantly lower than that of baseline (P<0.01). BIS score correlated negatively with propofol serum concentration within 15 minutes after operation. Conclusion BIS can be used to judge the depth of intravenous anesthesia. Compared with Tp,BIS is more accurate and sensitive.