• 1四川省巴中市巴中區(qū)城西醫(yī)院麻醉科,四川巴中 635500;2四川大學(xué)華西醫(yī)院麻醉科,四川成都 610041;3鄭州大學(xué)第一附屬醫(yī)院麻醉科,河南鄭州 450000;

目的:研究老年患者依托咪酯靶控輸注時不同BIS值(腦電雙頻指數(shù))的HRV(心率變異性)的變化情況,探討不同鎮(zhèn)靜深度與HRV之間的關(guān)系。方法:選擇65歲以上行門診胃鏡檢查患者30例,隨機(jī)分為3組,A組BIS45~55,B組55~65,C組65~75,各組均在麻醉前、麻醉誘導(dǎo)后,術(shù)中、術(shù)畢監(jiān)測BIS、HRV及血液動力學(xué)指標(biāo)。結(jié)果:A組各監(jiān)測HRV明顯降低(P lt;0.05),B組僅有輕度下降(P gt;0.05),C組明顯升高(P lt;0.05)。結(jié)論:患者鎮(zhèn)靜深度BIS55~65時,即可明顯抑制內(nèi)鏡操作刺激所致的HRV變化,是臨床較為合適的鎮(zhèn)靜深度,可顯著降低老年患者交感神經(jīng)活性、交感/迷走神經(jīng)均衡性和自主神經(jīng)總張力,利于機(jī)體血液動力學(xué)穩(wěn)定。

引用本文： 馬友兵,林彥俊,王宏偉. 依托咪酯靶控輸注用于老年患者快通道麻醉時BIS與HRV關(guān)系的研究. 華西醫(yī)學(xué), 2009, 24(9): 2295-2297. doi: 復(fù)制

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  1. 1. BERGEN JM, SMITH DC. A review of etomidate for rapid sequence intubation in the emergency department[J]. J Emerg Med, 1997, 15(2): 221-230.
  2. 2. GEPTS E. Pharmacokinetic concepts for TCI anaesthesia[J]. Anaesthesia, 1998, 53 Suppl 1: 4-12.
  3. 3. MARCIANI RD. Critical systemic and psychosocial considerations in management of trauma in the elderly[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1999, 87(3): 272-280.
  4. 4. 徐建設(shè), 陳恒星, 陳輝, 劉高望, 譚琳玲. 依托咪酯對高齡和休克病人全麻誘導(dǎo)血液動力學(xué)的影響[J]. 第一軍醫(yī)大學(xué)學(xué)報, 2005, (08): 1060-1061.
  5. 5. KAZAMA T, TAKEUCHI K, IKEDA K, et al. Optimal propofol plasma concentration during upper gastrointestinal endoscopy in young, middleaged, and elderly patients[J]. Anesthesiology, 2000, 93(3): 662-669.
  6. 6. SARKAR M, LAUSSEN PC, ZURAKOWSKI D, SHUKLA A, KUSSMAN B, ODEGARD KC. Hemodynamic responses to etomidate on induction of anesthesia in pediatric patients[J]. Anesth Analg, 2005, 101(3): 645-650.
  7. 7. LALLEMAND MA, LENTSCHENER C, MAZOIT JX, BONNICHON P, MANCEAU I, OZIER Y. Bispectral index changes following etomidate induction of general anaesthesia and orotracheal intubation[J]. Br J Anaesth, 2003, 91(3): 341-346.
  8. 8. PUNJASAWADWONG Y, BOONJEUNGMONKOL N, PHONGCHIEWBOON A. Bispectral index for improving anaesthetic delivery and postoperative recovery[J]. Cochrane Database Syst Rev, 2007, (4): CD003843.
  9. 9. BERKENBOSCH JW, FICHTER CR, TOBIAS JD. The correlation of the bispectral index monitor with clinical sedation scores during mechanical ventilation in the pediatric intensive care unit[J]. Anesth Analg, 2002, 94(3): 506-511.
  10. 10. 曾輝, 蔡靜怡, 王靜, 郭小玉, 楊陽, 李方潔. 不同年齡和性別短程心率變異性對比分析[J]. 臨床心電學(xué)雜志, 2008, (02): 108-110.
  11. 11. 邱勇玉, 劉海妹, 包小英. 不同年齡段健康人心率變異性分析[J]. 衛(wèi)生職業(yè)教育, 2008, (12): 140-141.