文献类型：期刊文献

中文题名：麻醉意识指数与血流动力学变化的相关性研究

英文题名：Study on the correlation between anesthesia index and hemodynamic changes

作者：闫琪[1];贾谜谜[1];马尚文[2];冯晓雪[3];阎文军[1,3]

第一作者：闫琪

机构：[1]甘肃中医药大学研究生院,甘肃兰州730000;[2]宁夏医科大学研究生院,宁夏银川750000;[3]甘肃省人民医院麻醉手术科,甘肃兰州730000

第一机构：甘肃中医药大学党委研究生工作部、研究生院

年份：2020

卷号：4

期号：1

起止页码：25

中文期刊名：麻醉安全与质控

外文期刊名：Perioperative Safety and Quality Assurance

基金：国家自然科学基金(81560214,818602330);甘肃省卫生行业科研计划项目(GSWSKY-2015-01)

语种：中文

中文关键词：全凭静脉麻醉;血流动力学;麻醉意识指数;相关性

外文关键词：total intravenous anesthesia;hemodynamics;anesthesia index;correlation

摘要：目的观察全凭静脉麻醉手术中患者麻醉意识指数(Ai)与血流动力学变化的相关性。方法选取我院2018年6~12月择期全麻患者120例,年龄18~65岁,ASA分级Ⅰ或Ⅱ级。采用靶控输注丙泊酚和瑞芬太尼,静脉注射咪达唑仑、顺式阿曲库铵麻醉诱导,麻醉维持为靶控输注丙泊酚和瑞芬太尼,间断追加肌松药,根据Ai判断麻醉深度并调整丙泊酚、瑞芬太尼输入量将Ai维持在40~60。记录患者麻醉诱导前(T 0),气管插管前1 min(T 1),气管插管时(T 2),切皮时(T 3),手术结束时(T 4),拔管前(T 5)的心率(HR)、平均动脉压(MAP)和Ai,采用Pearson系数进行相关性分析。结果与T 1比较,MAP和Ai在T 0、T 2、T 3、T 4、T 5升高,HR在T 0、T 2增快(P<0.05);与T 3比较,MAP和Ai在T 0、T 4、T 5升高,HR在T 0、T 2增快(P<0.05);Ai和HR相关系数为0.333,呈正相关;Ai和MAP的相关系数为0.710,呈正相关(P<0.05)。结论Ai与血流动力学变化呈正相关关系,且MAP变化更好地反应麻醉深度变化。
Objective To observe the correlation between anesthesia index(Ai)and hemodynamic changes during total intravenous anesthesia.Methods One hundred and twenty American Society of Anesthesiologists physical statusⅠorⅡpatients aged 18-65 years,scheduled for elective general anesthesia,were selected,with target-controlled infusion of propofol and remifentanil,intravenous injection of midazolam and cisatracurium during induction.For maintaining the anesthetic state,propofol and remifentanil were continuously administered by target-controlled infusion,and muscle relaxants were added intermittently.Ai was taken as a measure for the depth of anesthesia and the infusion of propofol and remifentanil were adjusted to maintain Ai at 40-60.The values of HR(heart rate),MAP(mean arterial pressure)and Ai before induction(T 0),1 min before endotracheal intubation(T 1),during endotracheal intubation(T 2),at skin resection(T 3),at the end of the operation(T 4),before extubation(T 5)were observed and recorded.Pearson coefficient was used for correlation analysis.Results Compared with these values at T 1,MAP and Ai increased at T 0,T 2,T 3,T 4 and T 5,while HR increased at T 0 and T 2(P<0.05).Compared with these values at T 3,MAP and Ai increased at T 0,T 4 and T 5,and HR increased at T 0 and T 2(P<0.05).The correlation coefficient between Ai and HR was 0.333,showing a positive correlation.The correlation coefficient between Ai and MAP is 0.710,which is positively correlated(P<0.05).Conclusion Ai is positively correlated with hemodynamic changes,and alterations of mean arterial pressure can better reflect changes in the depth of anesthesia.