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目的 :观察在异丙酚诱导期间 ,不同剂量芬太尼对脑电双频指数 (BIS)为参考指标的皮层功能状态的影响以及相应的血压心率变化。方法 :选择 40例ASAⅠ～Ⅱ级病人 ,随机分成四组 :Ⅰ组为对照组 ,Ⅱ、Ⅲ、Ⅳ组分别接受芬太尼 2 μg/kg、4μg/kg、8μg/kg ,静注生理盐水或芬太尼后 ,通过输液泵持续输注异丙酚使BIS稳定在 45± 5并维持 3分钟后插管。试验采用双盲法。结果 :置喉镜插管后 ,Ⅰ、Ⅱ组血压、心率较基础值明显升高 ,Ⅲ、Ⅳ组则升高不明显(P >0 0 5)、插管刺激使Ⅰ、Ⅱ、Ⅲ组BIS较插管前明显升高 ,而Ⅳ组BIS升高却不明显。SEF对插管刺激缺乏特异性变化。结论 :4μg/kg以上的芬太尼可以有效减弱插管所致的心血管反应 ,而 8μg/kg的芬太尼才可削弱置喉镜插管对皮层状态的激活 ,BIS不能预测气管插管引起的心血管反应
OBJECTIVE: To observe the effects of different doses of fentanyl on cortical functional status and corresponding changes of blood pressure and heart rate during propofol induction. Methods: Forty ASA Ⅰ ~ Ⅱ patients were randomly divided into four groups: group Ⅰ as control group, group Ⅱ, Ⅲ and Ⅳ received fentanyl 2 μg / kg, 4 μg / kg and 8 μg / kg respectively, Or fentanyl, propofol was infused continuously through the infusion pump to stabilize the BIS at 45 ± 5 for 3 minutes and then intubated. Test using double-blind method. Results: After laryngoscope intubation, the blood pressure and heart rate in group Ⅰ and group Ⅱ were significantly higher than those in group Ⅲ and Ⅳ (P> 0.05), while group Ⅰ, Ⅱ and Ⅲ BIS was significantly higher than before intubation, while the IV group BIS increased but not obvious. SEF lack of specific changes in intubation stimuli. CONCLUSION: Fentanyl above 4 μg / kg can effectively reduce the cardiovascular response caused by intubation, while 8 μg / kg of fentanyl can weaken the activation of cortical state by laryngoscope insertion. BIS can not predict endotracheal intubation Caused by cardiovascular reactions