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目的探讨丙泊酚用于无痛胃镜检查中的最佳镇静深度及适宜的脑电双频指数(BIS)值,同时检验 BIS 作为控制变量在丙泊酚输注过程调控的可操作性和实用性。方法 160例胃镜患者,根据丙泊酚注入后患者 BIS 的不同改变,随机分为4组(每组40例),A 组 BIS 降至80～75时;B 组 BIS 降至65～74时;C 组 BIS 降至55～64时;D 组 BIS 降至<55时停止首次给药。监测血压、心率、呼吸频率 SpO_2值、BIS 值及进镜顺利率。结果 A、B、C、D 各组丙泊酚的首次用量分别为:(1.15±0.34)mg/kg;(1.43±0.27)mg/kg;(1.78±0.31)mg/kg;(2.15±0.27)mg/kg,组间两两比较,差异有统计学意义(P<0.05)。进镜顺利率分别为17.5%、47.5%、92.5%、97.5%,C、D 间差异无统计学意义,其余各组间差异均有统计学意义(P<0.05)。D 组心率、血压下降明显(P<0.05)。结论应用 BIS 监测患者的麻醉镇静深度和调控丙泊酚的用量是安全、有效的,对于消化胃镜检查的最佳 BIS 区间为55～64。
Objective To investigate the best sedation depth and suitable bispectral index (BIS) value of propofol for painless gastroscopy and to test the feasibility and practicality of BIS as a control variable in the process of propofol infusion Sex. Methods One hundred and sixty patients undergoing gastroscopy were randomly divided into 4 groups (40 cases in each group) according to the changes of BIS in patients after propofol infusion. The BIS in group A decreased to 80-75 hours. The BIS in group B decreased to 65-74 hours. BIS in group C dropped to 55-64, and in group D, the first administration was stopped when the BIS dropped to <55. Monitoring blood pressure, heart rate, respiratory rate SpO_2 value, BIS value and smooth into the mirror rate. Results The first doses of propofol in groups A, B, C and D were (1.15 ± 0.34) mg / kg, (1.43 ± 0.27) mg / kg, (1.78 ± 0.31) mg / kg, (2.15 ± 0.27 ) mg / kg, there was a significant difference between two groups (P <0.05). The follow-up rate of follow-up was 17.5%, 47.5%, 92.5% and 97.5%, respectively. There was no significant difference between C and D (P <0.05). Heart rate and blood pressure in group D decreased significantly (P <0.05). Conclusion It is safe and effective to monitor the anesthetic sedation depth and the dosage of propofol in patients with BIS. The best BIS interval for digestive endoscopy is 55-64.