脑电双频指数反馈调控老年肿瘤患者靶控输注丙泊酚

摘要

目的：探讨脑电双频指数（ bispectral index，BIS）反馈调控老年肿瘤患者靶控输注丙泊酚的临床研究。方法：选择2012年10月-2014年10月在我院行胃癌根治术以及直肠癌根治术的128例老年患者，随机分为A组67例、B组61例。A组根据BIS反馈调控靶控输注丙泊酚，而B组根据麻醉医师经验调节丙泊酚输注。记录两组患者入室前（T0）、插管时（T1）、插管后5min（T2）、切皮即刻（T3）、肿瘤切除即刻（T4）、手术结束（T5）时BIS、DBP、SBP、HR变化情况，并计算两组患者丙泊酚用量。结果：在T2、T3、T4时间，B组患者DBP、SBP均显著低于A组（P﹤0.05）。而术中各时间，两组患者HR变化无显著差异（P﹥0.05）。在T2、T3、T4、T5时间，B组患者BIS显著低于A组（P﹤0.05）。A组丙泊酚用量为（704.25±100.42）mg，B组丙泊酚用量为（938.53±125.64）mg，两组丙泊酚用量比较，差异具有统计学意义（ P﹤0.05）。结论：老年肿瘤患者采用麻醉深度指数反馈调控靶控输注丙泊酚，有利于保持患者术中血流动力学的平稳，并且有利于避免麻醉药物的过度使用，是一种安全可行的麻醉监测方式。%Objective:To explore the anesthesia depth index( BIS)in elderly cancer patients of feedback regula-tion of target controlled infusion of propofol. Methods:All 128 elderly patients with gastric cancer underwent radical resection and radical resection of rectal cancer,were randomly divided into A group(67 cases),61 cases in group B. A group according to the BIS feedback target controlled infusion of propofol,group B according to the experience of anesthesiologists adjusting propofol infusion. Before into operation room(T0),before intubation(T1),5min after in-tubation(T2),skin incision(T3),tumor resection and immediate(T4),the end of operation(T5),BIS,DBP,SBP, HR changes,dosage of propofol were observed. Results:At T2,T3,T4,DBP,SBP in group B were significantly lower than those in group A(P﹤0. 05). Time during the operation in the two groups had no significant difference(P﹥0. 05). HR changes in T2,T3,T4,T5,in group B BIS was significantly lower than that of A group(P﹤0. 05). The dosage of propofol in group A was(704. 25 ± 100. 42)mg,in group B was(938. 53 ± 125. 64)mg(P﹤0. 05). Con-clusion:Elderly patients with anesthesia depth index feedback target controlled infusion of propofol is conducive to maintaining hemodynamics with stable,and helps to avoid excessive use of narcotic drugs,is a safe and feasible anes-thesia monitoring.