靶控输注不同浓度舒芬太尼对丙泊酚TCI镇静催眠的影响

目的在麻醉诱导期观察靶控输注（TCI）不同浓度舒芬太尼对丙泊酚镇静催眠效应的影响。方法 60例择期手术全麻患者,年龄25～60岁,ASAⅠ～Ⅱ级。随机分为4组,每组15例。A组为单纯丙泊酚组;B、C、D组为丙泊酚＋舒芬太尼组,舒芬太尼的靶效应浓度分别为0.1、0.2、0.3ng/ml。B、C、D组在TCI舒芬太尼达平衡后,TCI丙泊酚。记录舒芬太尼达平衡后1min和丙泊酚效应浓度达1.0、1.5、2.0、2.5、3.0μg/ml时的脑电双频谱指数（BIS）和OAA/S评分。结果在单纯输注舒芬太尼期间,BIS和OAA/S评分无明显变化;随丙泊酚浓度升高,患者BIS和OAA/S评分逐渐下降;相同丙泊酚浓度时,各组间的BIS值无明显差别;丙泊酚浓度为1.0、1.5、2.0μg/ml时,D组的OAA/S评分（4.1±0.3、4.3±0.7、3.1±1.1）明显低于A组（4.1±0.7、3.1±1.3、2.1±1.0,P〈0.05）。结论麻醉诱导期间输注0.1ng/ml和0.2ng/ml浓度的舒芬太尼不增强丙泊酚的镇静催眠效应,0.3ng/ml的舒芬太尼可以增加丙泊酚的镇静催眠效应。

Effects of different TCI concentrations of sufentanil on sedation and hypnosis effects of TCI propofol

Objective To estimate the effects of TCI different concentrations of sufentanil on sedation and hypnosis effects of TCI propofol. Methods Sixty patients, ASAⅠ～Ⅱ, aged 25～60 years old, were enrolled and divided randomly into four groups. Group A received TCI propofol alone, group B, C and D received TCI sufentanil before TCI propofol and effect site target concentration(Ct) of sufentanil were 0.1, 0.2 and 0.3 ng/ml respectively. Target concentration (Ct) of propofol was increased step-by-step from 1 to 3 μg/ml in five steps. Only after the Ct of propofol was maintained at each step for 1 min, OAA/S and bispectral index (BIS) were recorded. OAA/S and BIS were also recorded after 1 min of Ct of sufentanil was reached. Results TCI sufentanil alone did not affect patients’ BIS and OAA/S. BIS and OAA/S decreased with increase of propofol Ct in all groups. At the same Ct of propofol, there was no significant difference in BIS among all groups. OAA/S in group D was significantly lower than that in group A when the Ct of propofol was 1.0～2.0 μg/ml (P < 0.05). Conclusions During period of induction, sufentanil of effect concentrations at 0.1 and 0.2 ng/ml does not enhance sedation and hypnosis effects of propofol. Sufentanil in 0.3ng/ml may enhance sedation and hypnosis effects of propofol.