肝癌射频消融发热对丙泊酚全凭静脉麻醉深度的影响

目的:探讨应用脑电双频谱指数监测和评估射频消融发热对丙泊酚全凭静脉麻醉(TIVA)深度的影响。方法:40例ASAⅠ~Ⅱ级择期行肝癌射频消融术患者随机分为对照组和试验组,均用脑电双频指数(B IS)监测麻醉深度,对照组手术过程中行物理降温,保持体温在正常范围,试验组无降温处理,记录各时间段血压、心率、体温、脑电双频指数(B IS)、丙泊酚靶控浓度,统计丙泊酚使用总量及麻醉苏醒时间。结果:试验组与对照组比较,丙泊酚靶控浓度高、用量多(P<0.05);血压、心率、B IS显著升高,苏醒时间延长(P<0.01)。结论:肝癌射频消融术患者术中体温升高可引起麻醉深度改变及丙泊酚用量增多,术中应使用物理降温。

Effects of Fever Caused by Radiofrequency Ablation of Liver Tumors on Depth of Anesthesia with Propofol TIVA

Objective To investigate the effects of fever caused by radiofrequency ablation of liver tumors on depth of anesthesia with propofol TIVA.Methods Forty ASA Ⅰ～Ⅱpatients scheduled for Radiofrequency ablation of liver tumors were randomly divided into two groups:P and Control group,each group has received BIS monitor as depth index of anesthesia,group C received physical cooling to keep body temperture at the normal range,group P received no physical cooling.BP(SBP,DBP,MAP),HR and BIS were recorded before induction of anesthesia(baseline),at the time after operation 30min,60min,90min,120min,150min and at the end of operation.The total usage amount of propofol and awakening time were recorded.Results The propofol usage amount and the target plasma concentration of Group P were higher than group C(P<0.01);The BIS value,HR,BP of group P were increassd significantly(P<0.01),the awakening time was significant prolonged than group C(P<0.01).Conclusion The fever of radiofrequency ablation of liver tumor patients could increase the usage amount of propofol,and could change the depth of anesthesia.During operation,patients should receive physical cooling to keep body temperature at the normal range.