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目的 以脑电双频指数 (BIS)作为麻醉镇静深度的监测手段 ,比较泵输注与手控输注在胃镜检查中的麻醉效果 ,探讨泵输注异丙酚行静脉麻醉的安全有效剂量。方法 美国麻醉医师学会建议的术前病人综合状况评级Ⅰ～Ⅱ级、行择期全麻胃镜检查病人 4 8例 ,均分为泵输注 (T)组和手控输注(M )组。两组均先静脉注射芬太尼 1μg/kg体重。T组异丙酚血药浓度从 1μg/ml开始 ,以 0 .5 μg/ml递增 ,待病人BIS值低于 6 0后置入胃镜 ,镜检过程中血药浓度维持于 2～ 3μg/ml。M组异丙酚以 4 g/h速度诱导 ,镜检过程中异丙酚 4～ 6mg·h-1·kg-1维持麻醉。镜检时以BIS 4 0～ 6 0之间来反馈调节麻醉深度。两组均于活检完成后停止输注。计算患者从麻醉诱导至镜检开始的时间 (T1)、镜检持续时间(T2 )、睁眼时间 (T3)和检查室内总滞留时间 (即定向力恢复并出院 ,T4 ) ;以及麻醉诱导用量 (P1)、总用药量 (P2 )和平均输注速率 (V)。结果 2组间T1差异有显著性 (P =0 .0 4 8) ,T2、T3、T4差异无显著性。M组P1和P2均高于T组 ,差异有显著性 (P <0 .0 1)。 2组间V差异无显著性 (P =0 .0 96 )。 2组患者在镜检开始和睁眼时的BIS值基本相近 (T和M分别为 4 7.6 3± 6 .2 3和 4 7.6 7± 10 .78;76 .88± 7.0 8和78.2 1± 5 .34)。T组开始?
Objective To compare the effects of pump infusion and manual infusion on endoscopy anesthesia with bispectral index (BIS) as the monitoring method for anesthetic sedation depth and to explore the safe and effective dose of venous anesthesia with pump infusion of propofol. Methods The American College of Anesthesiologists recommended preoperative patients comprehensive status grade Ⅰ ~ Ⅱ, patients undergoing elective general anesthesia gastroscopy 48 patients were divided into pump infusion (T) group and manual infusion (M) group. Both groups were given intravenous fentanyl 1μg / kg body weight. T group propofol plasma concentration starting from 1μg / ml, 0.5μg / ml increments, until the patient BIS value of less than 60 into the gastroscope, microscopic examination during maintenance of plasma concentration of 2 ~ 3μg / ml . Propofol was induced at 4 g / h in group M, and propofol 4 ~ 6 mg · h-1 · kg-1 was maintained during the microscopic examination. Microscopic examination with BIS 40 ~ 60 between the feedback to adjust the depth of anesthesia. Both groups stopped infusion after the biopsy was completed. The time (T1), the duration of microscopic examination (T2), the time of open eyes (T3) and the total laboratory residence time (that is, the recovery of the directional force and the release of T4) were calculated from the induction of anesthesia to the start of microscopic examination; (P1), total dose (P2) and mean infusion rate (V). Results There was a significant difference in T1 between the two groups (P = 0.048). There was no significant difference between T2, T3 and T4. P1 and P2 of M group were higher than that of T group, the difference was significant (P <0.01). There were no significant differences in V between the two groups (P = .096). The BIS values were similar between the two groups at the beginning of microscopic examination and with open eyes (T and M were 4 7.63 ± 6.23 and 4 7.67 ± 10.78; 76.88 ± 7.08 and 78.2 1 ± 5, respectively .34). T group began?