全麻诱导行气管插管和喉罩置入对定量药物脑电图α1频段的影响

摘要

目的 对比全麻诱导时行气管插管和喉罩置入对定量药物脑电图(QPEEG)α1频段的影响.方法 选取择期全麻手术患者40例,随机分为气管插管组(T组)和喉罩置入组(L组),每组20例.分别记录2组患者麻醉诱导前(T0)、诱导后(T1)、插入气管插管或喉罩置入后(T2)的心率(HR)、平均动脉压(MAP)和QPEEG,利用功率谱分析技术计算QPEEG的α1频段的功率百分比.结果 与T0时刻比较,T1时刻2组患者的HR、MAP和大部分脑区的α1频段百分比均有所下降(P＜0.05);与T1时刻相比,T2时刻T组HR、MAP和α1频段百分比均有所上升(P＜0.05),L组则无明显改变(P＞0.05).结论 与喉罩置入相比,气管插管对循环系统的刺激更为强烈,并可引起QPEEG的α1频段功率百分比增加,提示QPEEG的α1频段可作为反映刺激强弱的指标.%Objective To compare the effects of tracheal intubation (TI) and laryngeal mask (LM) during general anesthesia (GA) induction on the α 1-band of quantitative pharmaco-electroencephalography (QPEEG).Methods Fortypatients undergoing GA were randomly divided into two groups:group T included 20 patients who received TI and group L included 20 who received a LM.Parameters like heart rate (HR),mean arterial pressure (MAP),and QPEEG were recorded before anesthesia induction (T0),after induction (T1),and after intubating the cannula or LM (T2).Using power-spectrum analysis,we calculated the power percentage of the α 1-band of QPEEG.Results The HR,MAP,and power percentage of the α 1-band in most areas of the brain were lower at T1 than at T0 (P ＜ 0.05) in both groups.Moreover,the HR,MAP,and α 1-band power percentage were higher at T2 than at T1 (P ＜ 0.05) in group T,whereas they showed no significant change at T2 (P ＞ 0.05) in group L.Conclusion TI is stronger than LM for stimulating the circulatory system.Moreover,TI may cause an increase in the power percentage of the α 1-band of QPEEG.This finding suggests that the α1-band power percentage of QPEEG can be an effective means of monitoring stimulation.