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超声监测下不同剂量舒芬太尼麻醉后瞳孔直径变化。

Pupil Diameter Changes after Anesthesia with Different Doses of Sufentanil under Ultrasound Monitoring.

机构信息

Department of Anesthesia, The Second Affiliated Hospital of Soochow University, Suzhou 215026, China.

出版信息

Int J Clin Pract. 2022 Jul 14;2022:6320973. doi: 10.1155/2022/6320973. eCollection 2022.

Abstract

OBJECTIVE

This study aims to observe the changes in pupil diameter (PD) after anesthesia with different doses of sufentanil with the ultrasound method and observe whether pupil contraction is correlated with hemodynamic changes and bispectral index (BIS) values.

METHODS

A total of 124 patients between the ages of 18-65 with ASA I-II undergoing general anesthesia for surgery were enrolled in the study. According to the sufentanil dose initially injected, they were randomly divided into groups P, S1, S2, and S3, with 31 cases in each group. Group P was injected with normal saline. Group S1 was injected with 0.2 g/kg of sufentanil. Group S2 was injected with 0.4 g/kg of sufentanil. Group S3 was injected with 0.6 g/kg of sufentanil. Following propofol administration and eye closure, the pupil diameter (PD) of the patients in the four groups was observed and measured by ultrasound after the loss of consciousness (T1) and within 3 min after the sufentanil injection at an interval of 30 s (30 s (T2), 1 min (T3), 1 min 30 s (T4), 2 min (T5), 2 min 30 s (T6), and 3 min (T7)). PD, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and BIS values at T1-T7 were recorded.

RESULTS

The ultrasonic method was used to observe that different doses of sufentanil could make the patients' pupils contract. During anesthesia induction, the changes in PD have a positive correlation with SBP, DBP, HR, and BIS values.

CONCLUSION

Ultrasound can become a new noninvasive method to monitor pupil changes during general anesthesia, and ultrasonic observation of pupil changes has great potential for individualized analgesia management in the perioperative period.

摘要

目的

本研究旨在通过超声方法观察不同剂量舒芬太尼麻醉后瞳孔直径(PD)的变化,并观察瞳孔收缩是否与血流动力学变化和脑电双频指数(BIS)值相关。

方法

选择年龄 18-65 岁、ASA 分级 I-II 级、拟行全身麻醉手术的患者 124 例,按舒芬太尼初始注射剂量分为 P 组、S1 组、S2 组、S3 组,每组 31 例。P 组给予生理盐水,S1 组给予 0.2μg/kg 舒芬太尼,S2 组给予 0.4μg/kg 舒芬太尼,S3 组给予 0.6μg/kg 舒芬太尼。静脉注射异丙酚,闭眼后观察患者瞳孔直径(PD),在意识消失(T1)后和舒芬太尼注射后 3min 内,每隔 30s 用超声测量 1 次,共测量 7 次(30s(T2)、1min(T3)、1min30s(T4)、2min(T5)、2min30s(T6)、3min(T7))。记录 T1-T7 时的 PD、收缩压(SBP)、舒张压(DBP)、心率(HR)和 BIS 值。

结果

超声方法观察到不同剂量的舒芬太尼可以使患者的瞳孔收缩。麻醉诱导期间,PD 的变化与 SBP、DBP、HR 和 BIS 值呈正相关。

结论

超声可以成为一种新的非侵入性监测全身麻醉期间瞳孔变化的方法,超声观察瞳孔变化在围手术期个体化镇痛管理中有很大的应用潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/216c/9303082/6022a2a6aa61/IJCLP2022-6320973.002.jpg

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