Mahli Ahmet, Coskun Demet, Karaca Gozde Inan, Akcali Didem T, Karabiyik Lale, Karadenizli Yener
Department of Anaesthesiology and Reanimation, School of Medicine, Gazi University, Besevler, Ankara, Turkey.
J Res Med Sci. 2011 May;16(5):611-20.
Our objective was to examine the clinical properties of two anesthetic regimens, propofol target-controlled infusion (TCI), or desflurane using remifentanil TCI under bispectral index (BIS) guidance during ear, nose, and throat (ENT) procedures.
FORTY CONSENTING PATIENTS WHO SCHEDULED FOR ENT PROCEDURES WERE PROSPECTIVELY STUDIED AND WERE INCLUDED IN ONE OF THE TWO GROUPS: TCI group or desflurane (DES) group. General anesthesia was induced with 3 ng mL(-1) and 4 μg mL(-1) effect site concentrations (Ce) of remifentanil and propofol, respectively, with TCI system. After intubation, while propofol infusion was continued in the TCI group, it was ceased in the DES group and desflurane with an initial delivered fraction of 6% was administered. The Ce of propofol infusion and inspired fraction of desflurane was adjusted in order to keep BIS as 50 ± 10.
General mean values of mean arterial pressure (MAP) and heart rate (HR) for the TCI group was significantly higher than DES group (89.3 mmHg and 72.4 bpm vs. 77.1 mmHg and 69.5 bpm). Early emergence from anesthesia did not significantly differ between the groups. The rate of patients' Aldrete score (ARS) to reach 10 was found to be 100% at the 15(th) min in both groups.
Bispectral index guided combinations of remifentanil TCI either with propofol TCI or desflurane anesthetic regimens are both suitable for patients undergoing ENT surgery. The lower blood pressure in the remifentanil TCI with desflurane anesthetic regimens may be a significant advantage.
我们的目的是研究两种麻醉方案的临床特性，即在双谱指数（BIS）引导下，于耳鼻喉（ENT）手术过程中使用丙泊酚靶控输注（TCI）或地氟醚复合瑞芬太尼TCI。
对40例同意接受ENT手术的患者进行前瞻性研究，并将其纳入两组之一：TCI组或地氟醚（DES）组。使用TCI系统，分别以3 ng/mL和4 μg/mL的瑞芬太尼和丙泊酚效应室浓度（Ce）诱导全身麻醉。插管后，TCI组继续输注丙泊酚，DES组则停止输注丙泊酚，开始给予初始浓度为6%的地氟醚。调整丙泊酚输注的Ce和地氟醚的吸入浓度，以使BIS保持在50±10。
TCI组的平均动脉压（MAP）和心率（HR）总体平均值显著高于DES组（89.3 mmHg和72.4次/分钟 vs. 77.1 mmHg和69.5次/分钟）。两组患者麻醉后早期苏醒情况无显著差异。两组患者在第15分钟时Aldrete评分（ARS）达到10分的比例均为100%。
BIS引导下瑞芬太尼TCI联合丙泊酚TCI或地氟醚麻醉方案均适用于接受ENT手术的患者。瑞芬太尼TCI联合地氟醚麻醉方案导致的血压较低可能是一个显著优势。
