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目的探讨艾司洛尔对脑电图双频指数(B IS)的影响。方法选择30例,ASA I~Ⅱ级在异丙酚(4μg/m l)麻醉下行腹腔镜手术的病例,随机分为3组:生理盐水组、瑞芬太尼组(4ng/m l)和艾司洛尔组(225μg.kg-1.mm-1)。异丙酚、瑞芬太尼和艾司洛尔均采用计算机控制输注装置(CAC I)给予。观察3组病人在麻醉诱导和气管插管前后血流动力学与脑电图双频指数(B IS)的变化。结果3病人在气管插管前心率(HR)、平均动脉压(MAP)和B IS无显著差异。气管插管后,生理盐水组B IS明显升高△B IS(31±16)%,瑞芬太尼组△B IS(8±10)%,艾司洛尔组△B IS(7±11)%(P<0.01)。3组病人在气管插管后△HR和△MAP均明显升高,但生理盐水组比瑞芬太尼组和艾司洛尔组升高更明显[MAP(59±26)%VS(43±22)%VS(39±18)%(P<0.01),HR(39±18)%VS(22±12)%VS(15±14)%(P<0.05)]。瑞芬太尼组与艾司洛尔组的血流动力学和B IS的变化无显著差异(P<0.05)。结论艾司洛尔不仅能抑制肾上腺素能反应,而且能在异丙酚麻醉中抑制B IS觉醒反应。
Objective To investigate the influence of esmolol on the bispectral index (B IS) of EEG. Methods Thirty patients undergoing laparoscopic surgery under propofol (4μg / ml) anesthesia were randomly divided into three groups: saline group, remifentanil group (4ng / ml) and Esch Lol group (225 μg.kg-1.mm-1). Propofol, remifentanil and esmolol were administered using a computer controlled infusion device (CAC I). The changes of hemodynamics and bispectral index (B IS) before and after anesthesia induction and intubation were observed in 3 groups of patients. Results There was no significant difference in heart rate (HR), mean arterial pressure (MAP) and B IS before intubation in 3 patients. After tracheal intubation, the B IS in the saline group was significantly higher than those in the control group (△ B IS (31 ± 16)%, △ B IS (8 ± 10)% in the remifentanil group and △ B IS )% (P <0.01). The △ HR and △ MAP of the three groups were significantly increased after tracheal intubation, but were significantly higher in the saline group than those in the remifentanil group and esmolol group [MAP (59 ± 26)% VS (43 ± 22)% VS (39 ± 18)% (P <0.01), HR (39 ± 18)% VS (22 ± 12)% VS (15 ± 14)% (P <0.05)]. There were no significant differences in hemodynamics and B IS between remifentanil group and esmolol group (P <0.05). Conclusion Esmolol not only inhibits the adrenergic response, but also inhibits B IS arousal in propofol anesthesia.