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右美托咪定对丙泊酚和瑞芬太尼靶控输注麻醉期间脑电双频指数和听觉诱发电位指数的影响

[Effect of dexmedetomidine on bispectral index and auditory evoked potential index during anesthesia with target controlled infusion of propofol and remifentanyl].

作者信息

Li Hui-ling, She Shou-zhang, Yan Yan, Zhu Sheng-mei

机构信息

Department of Anesthesiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

出版信息

Zhejiang Da Xue Xue Bao Yi Xue Ban. 2010 Jan;39(1):84-8. doi: 10.3785/j.issn.1008-9292.2010.01.014.

Abstract

OBJECTIVE

To evaluate the effect of dexmedetomidine (Dex) on bispectral index (BIS) and auditory evoked potential index (AAI) during anesthesia with target controlled infusion (TCI) of propofol and remifentanyl.

METHODS

Thirty adult patients (ASA I approximate, equalsII) who were scheduled for elective thyroidectomy were monitored with BIS, AAI, ECG, blood pressure, end-tidal CO(2), and pulse oximeter before and during anesthesia. Anesthesia was induced by TCI with propofol 4 mg/L and remifentanyl 1 mu g/kg. After loss of consciousness the patients were intubated after rocuronium 0.6 mg/kg intravenous injection, remifentanyl was then infused at 0.2 microg/(kg x min)(-1) and propofol infusion (Ct) was titrated to maintain a BIS value at 50 +/- 3. At 10 min after stabilization of anesthesia the patients were randomly and double-blindly divided into 2 groups: Group D (n=15) received Dex 0.4 mu g/kg iv administered over 5 min and Group C (n=15) received equal volume of normal saline. Values of BIS, AAI, MAP, HR were recorded every 2 min within 20 min after the administration of the drugs.

RESULTS

Before anesthesia the BIS index was 90 +/- 2 in Group D and 92 +/- 2 in Group C, AAI was 81 +/- 1 in Group D and 78 +/- 1 in Group C. In anesthesia with target controlled infusion of propofol, BIS index showed a significant decrease with the i.v. administration of Dex 0.4 microg/kg, while AAI remained unchanged. In Group C, both of BIS and AAI remained unchanged after saline injection.

CONCLUSION

During propofol and remifentanyl anesthesia, after the administration of Dex, BIS value demonstrates a predominant decrease, whereas AAI shows no changes.

摘要

目的

评估右美托咪定(Dex)对丙泊酚和瑞芬太尼靶控输注(TCI)麻醉期间脑电双频指数(BIS)和听觉诱发电位指数(AAI)的影响。

方法

30例拟行择期甲状腺切除术的成年患者(美国麻醉医师协会分级I或II级),在麻醉前及麻醉期间用BIS、AAI、心电图、血压、呼气末二氧化碳分压和脉搏血氧饱和度仪进行监测。采用TCI丙泊酚4mg/L和瑞芬太尼1μg/kg诱导麻醉。意识消失后静脉注射罗库溴铵0.6mg/kg行气管插管,然后以0.2μg/(kg·min)-1输注瑞芬太尼,丙泊酚输注浓度(Ct)滴定以维持BIS值在50±3。麻醉稳定10分钟后,患者随机双盲分为2组:D组(n=15)静脉注射Dex 0.4μg/kg,持续5分钟;C组(n=15)静脉注射等体积生理盐水。给药后20分钟内每2分钟记录BIS、AAI、平均动脉压(MAP)、心率(HR)值。

结果

麻醉前,D组BIS指数为90±2,C组为92±2;D组AAI为81±l,C组为l78±1。在丙泊酚靶控输注麻醉中,静脉注射0.4μg/kg Dex后BIS指数显著下降,而AAI保持不变。C组注射生理盐水后BIS和AAI均保持不变。

结论

在丙泊酚和瑞芬太尼麻醉期间,注射Dex后BIS值显著下降,而AAI无变化。

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