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芬太尼在异丙酚诱导期间对脑电双频指数及血压心率的影响 |
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赵荣辉 王俊科 傅文
摘要 目的：观察在异丙酚诱导期间，不同剂量芬太尼对脑电双频指数（BIS）为参考指标的皮层功能状态的影响以及相应的血压心率变化。方法：选择40例ASAⅠ～Ⅱ级病人，随机分成四组：Ⅰ组为对照组，Ⅱ、Ⅲ、Ⅳ组分别接受芬太尼2μg／kg、4μg／kg、8μg／kg，静注生理盐水或芬太尼后，通过输液泵持续输注异丙酚使BIS稳定在45±5并维持3分钟后插管。试验采用双盲法。结果：置喉镜插管后，Ⅰ、Ⅱ组血压、心率较基础值明显升高，Ⅲ、Ⅳ组则升高不明显（P＞0.05）、插管刺激使Ⅰ、Ⅱ、Ⅲ组BIS较插管前明显升高，而Ⅳ组BIS升高却不明显。SEF对插管刺激缺乏特异性变化。结论：4μg／kg以上的芬太尼可以有效减弱插管所致的心血管反应，而8μg／kg的芬太尼才可削弱置喉镜插管对皮层状态的激活，BIS不能预测气管插管引起的心血管反应。
关键词 异丙酚 芬太尼 双频指数 血流动力学
Response of Cardiovascular and Electroencephalographic Variables during
Induction with Propofol and Different Doses of Fentanyl
Zhao Ronghui，Wang Junke，Fu wen
Department of Anesthesiology，First Affiliated Hospital，China Medical University，Shenyang，110001
Abstract Objective：To oberserve changes of EEG parameters，including bispectral index（BIS），spectral edge frequency（SEF） and hemodynamic response to intubation during induction by propofol with different doses of fentanyl．Methods: 40 ASAⅠ-Ⅱ patients were randomly assigned to four groups:iv normal saline（group Ⅰ），fentanyl 2μg／kg（groupⅡ），fentanyl 4μg／kg（group Ⅲ） and fentanyl 8μg／kg（groupⅣ）．Intubation was performed following maintence of BIS at the level of 45±5 for 3min. EEG and cardiovascular variables were recorded at endpoints of pre-induction，pre-intubation and post-intubation．Results：In group Ⅰ and Ⅱ，post-intubation blood pressure and heart rate were significantly increased compared with pre-intubation values（P＜0.05），and not significant in group Ⅲ and group Ⅳ. In group Ⅰ，Ⅱ and Ⅲ BIS was increased to 50.5±5.5，51.2±3.9 and 52±5.8 respectively，while in group Ⅳ，no significant increase of BIS was noticed. Conclusion：Fentanyl 4μg／kg or more can effectively blunt the hemodynamic response to intubation，but only 8μg／kg fentanyl attenuates the arousal of cerebral activity．BIS cannot predict the cardiovacular response to intubation during induction．
Key words Propofol Fentan[1] [2] 下一页
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