雷米芬太尼对丙泊酚靶控输注诱导期间效应室浓度及麻醉深度的影响

摘要

Objective:To investigate the effect of remifentanil on the effect compartment concentration( EC) ,response entropy( RE) , state entropy(SE) and hemodynamical response during propofol target-controlled infusion(TCI) general anesthesia period. Methods:Twenty-two ASA classⅠ - II patients undergoing elective surgery were randomly divided into the experimental group and control group,eleven cases in each group. In the two groups,the plasma concentration was as the target objective to do TCI. The initial plasma concentration was set to 1. 5μg /ml,increased by 0. 5μg /ml every 4 minutes until the Modified Observer Assessment of Alertness and Sedation(MOAA/S) score=1. The patients in experimental group were received with remifentanil infusion at 0. 2 μg·kg-1·min-1, while the patients in control group were received with normal saline at 0. 2 μg·kg-1 ·min-1 . Tracheal intubation was operated after 3 minutes with muscular relaxants when MOAA/S was equal to 0. Propofol EC,RE,SE,mean arterial pressure(MAP) and heart rate ( HR) were recorded when anesthesia was inducted with propofol TCI, including before anesthesia ( T0 ) , at the time of infusion with muscle relaxants(T1),at the time of intubation(T2) and at 1 min after intubation(T3). Results:Propofol EC in experimental group was lower than that in control group at T1 -T3(P0. 05). MAP at T3 and HR at T1 -T3 in experimental group were lower than those in control group(P0.05)。观察组T3 MAP和T1~T3 HR均明显低于对照组(P<0.01)。结论：丙泊酚TCI诱导期间泵入雷米芬太尼使麻醉深度不变的情况下丙泊酚用量明显减少,血压和HR被抑制更明显。