全麻患者在异丙酚不同靶控浓度下罗库溴铵对脑电双频指数的影响

目的：探讨异丙酚在不同靶控浓度下．罗库溴铵对脑电双频指数（Bispectral index．BIS）监测麻醉深度的影响。。方法：ASA I级或II级择期手术患者60例．随机分为4组（n=15）：实验组（R2和R3）和对照组（C2和C3）。设定异丙酚初始效应室浓度（effect-site concentration．Ce）为4．0Hg／mL。当患者镇静警觉评分（0AA／S评分）≤1时置入喉罩。机械通气，调节异丙酚靶控浓度．使Ce维持在2．0μg／mL或3．0μg／mL．达到靶浓度后稳定20min．实验组（R2和R3）静脉注射2倍ED95剂量的罗库溴铵0．6mg／kg，对照组[C2和C3）注射生理盐水（5ml）。记录异丙酚诱导前即刻（T1），静脉注射罗库溴铵或生理盐水即刻（T2）、TOF消失为0对（T3）、TOF的第一个肌颤搐恢复到5％时（T4）BIS，HR．MAP值。结果：四组患者性别．年龄、体重之间差异无显著性罄异（P〉0．05）；对照组T1～T4各时点BIS值比较差异无统计学意义（P〉0．05）；与b对比较．R2组T3和T4时BIS降低（P〈0.05），但R3组、C2绍和C3组变化差异无统计学意义（P〉0．05）。实验组与相同异丙酚效应室浓度对照组比较．R2组．C2组与R3组、C3组在静脉注射罗库溴铵或生理盐水前后变化差异无统计学意义（P〉0．05）。结论：罗库澳铵对BIS值的影响与镇静深度有关。异丙酚靶控浓度维持在2．0μg／mL较浅的镇静状态下，静脉注射2倍ED95剂量的罗库澳铵可引起BIS数值的下降。但在3．0μg／mL较深的镇静状态下．2倍ED85剂量的罗库溴铵对BIS值无影响。

Influence of Rocuronium on Bispectral Index During Different Effect-site Concentration of Propofol

Objective：To investgate whether rocuronium can affect bispcetra/ index during different effect-site concentration of propofo） . Methods：Sixty ASA I or II patients undergoing elective surgery were enrollded in the study, based on Ce of propofol,the patients randomly divided into four groups （R2 and R3）and（C2 and C3）（n=15）.When the Ce of propofol reached 4.0μg/mL and OAA/S score was below one,a laryngeal mask airway was inserted,Ce was then maintained at 2.0μg/mL or 3.0μg/mL for 20min.Rocuronium 2ED950. 6 mg/kg was gived in groups R2and R3, normal saline（5ml） was gived in the other two groups . BIS. heart rate （HR） and mean arterial pressure（MAP）values were recorded before induction of propofol immediately（T1）,injection rocuronium or normal saline immediately（T2）,TOF reached 0（T3）, The first TOF twitch of muscle recovered to 5 % （14）. Results：There was no significant difference in sex, age, body weight among four groups（P〉0. 05）. There was no significant difference in BIS between groups C2 and C3 whenT1--T4（P 〉 0.05）.The BIS of T3and T4 were significantly lower than T2 in group R2 （ P〉0.05） but not in group R3, C2 and C3 （P〉0.05）. Compared with the same Ce,there was no significant difference between group R2,C2 and groupR3,C3（P〉0.05）. Conclusion：Rocuronium alters the BIS scores in moderately sedated patients but not in deeply sedated patients,the scores of BIS were decreased after a bolus 2 times ED95 of rocuronium when Ce of propofol set at 2.0μg/mL ,but Ce of propofol set at 3.0μg/mL,there were no change in BIS scores.