七氟醚吸入誘導插管期間腦電雙頻指數和血流動力學的變化_《中國循證醫學雜志》

作者：

黃偉 ¹ ,  王健 ¹ , 羅林麗 ² , 周軍 ¹

1.四川大學華西醫院麻醉科 (成都 610041) 2.四川大學華西第二醫院麻醉科(成都 610041);

關鍵詞：

七氟醚乙酰膽堿腦電雙頻指數血流動力學全身麻醉氣管插管

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目的　探討成人七氟醚吸入誘導復合小劑量乙酰膽堿氣管插管對腦電雙頻指數(BIS)和血流動力學的影響。
方法　采用全麻誘導后及氣管插管前后自身對照的試驗方法，選擇ASAI-II級非困難氣道、擇期手術病人30例，分別于全麻誘導前 (T1)、誘導后患者入睡時(T2)及氣管插管前(T3)、插管后1 min(T4)、插管后3 min(T5)時，監測BIS、心率(HR)及平均動脈壓(MAP) 。
結果　 BIS 在T1~T5時分別為：96.8±1.7、70.4±8.8 、39.2±8.4、43.6±12.9、41.6±9.3, 誘導后各時點BIS 值均低于誘導前（P lt;0.05）。T3~T5時的HR均較誘導前升高（P lt;0.05）。MAP在T2和T3時與T1比降低，T4時比T1升高（P lt;0.05）；但在T5時回到誘導前水平（P gt;0.05）。T4時的BIS值、MAP和HR值均顯著高于T3時（P lt;0.05）。術后隨訪無1例病人對誘導插管過程有記憶。
結論　七氟醚復合小劑量乙酰膽堿誘導插管，可提供較好的鎮靜和(或) 麻醉深度，但尚不能很好地消除氣管插管引起的不良應激反應。

引用本文： 黃偉,王健,羅林麗,周軍. 七氟醚吸入誘導插管期間腦電雙頻指數和血流動力學的變化. 中國循證醫學雜志, 2007, 07(12): 869-872. doi: 復制

1.	Muzi M, Robinson BJ, Ebert TJ,et al. Induction of anesthesia and tracheal intubation with sevoflurane in adults. Anesthesiology, 1996,85(3): 536-543.
2.	Ekman A, Lindholm ML, Lennmarken C, et al. Reduction in the incidence of awareness using BIS monitoring.Acta Anaesthesiol Scand, 2004, 48(1): 20-26.
3.	Myles PS, Leslie K, Forbes A, et al. Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomized controlled trial. Lancet, 2004,363 (9423): 1757-1763.
4.	Guignard B, Menigaux C,Dupont X,et al.The effect of remifentanil on the bispectral index change and hemodynamic responses after orotracheal intubation. Anesth Analg, 2000, 90(1): 161-167.
5.	Patel SS,Goa KL. Sevoflurane:A review of its pharmacodynamics and pharmacokinetic properties and its clinical use in general anaesthesia.Drugs,1996,51(4): 658-700.
6.	Edwards ND, Alford AM,Dobson PM, et al. Myocardial ischaemia during tracheal intubation and extubation. Br J Anaesth,1994, 73(4) : 537-539.
7.	Guignard B,Chauvin M. Bispectral index increases and decreases are not always signs of inadequate anesthesia. Anesthesiology, 2000,2(3): 903-905.
8.	El-Orbany MI, Joseph NJ, Salem MR, et al. The neuromuscular effects and tracheal intubation conditions after small doses of succinylcholine. Anesth Analg, 2004,98(6): 1680-1685.
9.	Kopman AF,Zhaku B,Lai KS. The “intubating dose” of succinylcholine: the effect of decreasing doses on recovery time.Anesthesiology, 2003,99(5): 1050-1043.

1. Muzi M, Robinson BJ, Ebert TJ,et al. Induction of anesthesia and tracheal intubation with sevoflurane in adults. Anesthesiology, 1996,85(3): 536-543.
2. Ekman A, Lindholm ML, Lennmarken C, et al. Reduction in the incidence of awareness using BIS monitoring.Acta Anaesthesiol Scand, 2004, 48(1): 20-26.
3. Myles PS, Leslie K, Forbes A, et al. Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomized controlled trial. Lancet, 2004,363 (9423): 1757-1763.
4. Guignard B, Menigaux C,Dupont X,et al.The effect of remifentanil on the bispectral index change and hemodynamic responses after orotracheal intubation. Anesth Analg, 2000, 90(1): 161-167.
5. Patel SS,Goa KL. Sevoflurane:A review of its pharmacodynamics and pharmacokinetic properties and its clinical use in general anaesthesia.Drugs,1996,51(4): 658-700.
6. Edwards ND, Alford AM,Dobson PM, et al. Myocardial ischaemia during tracheal intubation and extubation. Br J Anaesth,1994, 73(4) : 537-539.
7. Guignard B,Chauvin M. Bispectral index increases and decreases are not always signs of inadequate anesthesia. Anesthesiology, 2000,2(3): 903-905.
8. El-Orbany MI, Joseph NJ, Salem MR, et al. The neuromuscular effects and tracheal intubation conditions after small doses of succinylcholine. Anesth Analg, 2004,98(6): 1680-1685.
9. Kopman AF,Zhaku B,Lai KS. The “intubating dose” of succinylcholine: the effect of decreasing doses on recovery time.Anesthesiology, 2003,99(5): 1050-1043.

《中國循證醫學雜志》

七氟醚吸入誘導插管期間腦電雙頻指數和血流動力學的變化

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《中國循證醫學雜志》

七氟醚吸入誘導插管期間腦電雙頻指數和血流動力學的變化

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

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