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喷他佐辛增加无手术刺激时氧化亚氮-七氟醚麻醉的脑电双频指数。

Pentazocine increases bispectral index without surgical stimulation during nitrous oxide-sevoflurane anesthesia.

机构信息

Division of Anesthesiology, Department of Comprehensive Medical Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama, 350-0283, Japan.

出版信息

J Anesth. 2011 Dec;25(6):946-9. doi: 10.1007/s00540-011-1224-2. Epub 2011 Sep 9.

Abstract

Although there have been a large number of reports on the effects of opioids on the bispectral index (BIS) during anesthesia, the effects of pentazocine on the BIS have not been reported. In this study, 60 patients scheduled for elective oral surgery [30 females, 30 males; all American Society of Anesthesiologists Physical Status (ASA PS) category 1] were enrolled in the trials. Maintaining gender parity, we randomly assigned the patients to one of three groups: pentazocine group (0.3 mg/kg; n = 20), fentanyl group (1 μg/kg; n = 20), or saline group (n = 20); these opioids were administered intravenously 15 min after the intubation. Anesthesia was induced with thiopental and vecuronium bromide and maintained with nitrous oxide (4 l/min)-oxygen (2 l/min)-sevoflurane (1%). At 15 min after the intubation, mean arterial blood pressure (MAP), heart rate (HR), and BIS index were recorded as baseline values. MAP, HR, and BIS values were measured at 2.5-min after the intubation up to 30 min. All data were expressed as the mean ± standard deviation. Differences in BIS values, MAP, and HR among the three groups throughout the experiment were analyzed using two-way repeated-measures analysis of variance (ANOVA), and demographic data among the three groups were analyzed using one-way ANOVA. Post hoc comparisons were performed using Fisher's protected least significant difference test. A P value of <0.05 was considered to indicate statistically significance. MAP and HR showed no significant differences among the three groups during the study. BIS values significantly increased between 5 and 15 min after the intubation relative to the baseline value in the pentazocine group (P < 0.001), and BIS values in this group were significantly during this time period than those in the fentanyl and saline group (P < 0.001). BIS values were not significantly different between the fentanyl group and saline group. These results indicated that pentazocine, but not fentanyl, under nitrous oxide-sevoflurane anesthesia caused a statistically significant increase in BIS in our patients.

摘要

虽然有大量关于麻醉期间阿片类药物对双频谱指数(BIS)影响的报告,但关于戊唑辛对 BIS 的影响尚未见报道。在这项研究中,纳入了 60 名计划接受择期口腔手术的患者[30 名女性,30 名男性;所有美国麻醉医师协会身体状况(ASA PS)类别 1]。为了保持性别均衡,我们将患者随机分为三组:戊唑辛组(0.3mg/kg;n=20)、芬太尼组(1μg/kg;n=20)和生理盐水组(n=20);这些阿片类药物在插管后 15 分钟静脉给药。麻醉诱导采用硫喷妥钠和维库溴铵,并用氧化亚氮(4L/min)-氧气(2L/min)-七氟醚(1%)维持。插管后 15 分钟,记录平均动脉压(MAP)、心率(HR)和 BIS 指数作为基础值。在插管后 2.5 分钟至 30 分钟测量 MAP、HR 和 BIS 值。所有数据均表示为均数±标准差。使用双因素重复测量方差分析(ANOVA)分析三组患者在整个实验过程中 BIS 值、MAP 和 HR 的差异,使用单因素 ANOVA 分析三组患者的人口统计学数据。采用 Fisher 保护最小显著差异检验进行事后比较。P 值<0.05 表示具有统计学意义。在研究过程中,三组之间的 MAP 和 HR 没有显著差异。与戊唑辛组相比,插管后 5 至 15 分钟 BIS 值显著升高(P<0.001),且在此期间 BIS 值显著高于芬太尼组和生理盐水组(P<0.001)。芬太尼组和生理盐水组之间 BIS 值无显著差异。这些结果表明,在氧化亚氮-七氟醚麻醉下,戊唑辛而不是芬太尼会导致我们的患者 BIS 值出现有统计学意义的升高。

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