不同剂量地佐辛对丙泊酚靶控输注全身麻醉下BIS 和AEPI 的影响

Effect of different dosages of Dezocine on BIS and AEPI under general anesthesia with target-controlled injection of Propofol

摘要:

目的 探究不同剂量地佐辛对丙泊酚靶控输注全身麻醉下脑电双频指数（BIS）和听觉诱发电位指数（AEPI）的影响。方法 选取2014 年10 月-2015 年7 月于该院进行全身麻醉手术的100 例患者。按照随机数字法分为4 组，每组25 例，所有患者均实施丙泊酚靶控输注，维持麻醉及血流动力学稳定后，分别静脉滴注1μg/kg 芬太尼（F 组），0.05 mg/kg 地佐辛（D1 组），0.1 mg/kg 地佐辛（D2 组），0.15 mg/kg 地佐辛（D3组）。记录并比较各组患者全身麻醉诱导前（T）、给药前即刻（T0）、给药后每隔3 min 各时间点（T1~T5）的HR、MAP、BIS 及AEPI 值，最多记录至15 min。结果 F 组内部各个时间点的HR、MAP、BIS 和AEPI 值比较，差异无统计学意义（P >0.05）。与F 组各个时间点比较，D1 组的对应的HR、MAP、BIS 和AEPI 值升高，D2 组的HR 和MAP 值升高，均差异有统计学意义（P <0.05），而D3 组差异无统计学意义（P >0.05）。与T0时间点比较，D1 组的HR、MAP、BIS 和AEPI 值在各时间点升高，D2 组的HR、BIS 和AEPI 值升高，而D3组的MAP 值在T2 ～ T5 时间点升高，均差异有统计学意义（P <0.05）。结论 不同剂量地佐辛对丙泊酚全身麻醉患者的血流动力学参数及麻醉深度有一定影响，剂量为0.15 mg/kg 地佐辛可用于全身麻醉，可达有效的麻醉深度，维持术前稳定的血流动力学，值得临床推广应用。

Abstract:

Objective To investigate the effect of different dosages of Dezocine on bispectral index (BIS) and auditory-evoked potentials index (AEPI) under general anesthesia with target-controlled injection of Propofol. Methods Totally 100 patients who had operation under general anesthesia in our hospital from October 2014 to July 2015 were divided into 4 groups, with 25 patients in each group. All patients received target-controlled injection of Propofo1. They were then intravenously infused with 0.05, 0.10, 0.15 mg/kg Dezocine (group D1, D2,D3, respectively), or 1 μg/kg Fentanyl (group F). Heart rate (HR), mean arterial blood pressure (MAP), BIS and AEPI were measured before induction of general anesthesia (T), immediately before drug administration (T0), and every 3 min after administration up to 15 min. Results There were no significant differences among HR, MAP, BIS or AEPI values at different time points in the group F (P > 0.05). Compared with the values of the group F at each time point, HR, MAP, BIS and AEPI values of the group D1 increased significantly, HR and MAP values of the group D2 increased significantly (P < 0.05); but there were no significant differences between the group D3 and the group F at each time point (P > 0.05). Compared with the T0 values, HR, MAP, BIS and AEPI values of the group D1 increased significantly at other time points (P < 0.05), and HR, BIS and AEPI values of the group D2 increased significantly, MAP values of the group D3 significantly increased at T2-T5 (P < 0.05). Conclusions Different dosages of Dezocine have certain influence on hemodynamic parameters and depth of anesthesia in patients undergoing Propofol general anesthesia. General anesthesia can use 0.15 mg/kg Dezocine, which can achieve effective depth of anesthesia and maintain preoperative stable hemodynamics. It is worthy of clinical application.