BIS对吸毒患者无痛人流术中丙泊酚用量的指导作用

【目的】通过监测吸毒患者无痛人工流产（人流）术中的脑电双频指数（BIS ）寻找适合吸毒患者的丙泊酚用量。【方法】随机选取2009年至2013年在本院行无痛人流术的20例吸毒患者为试验组，并随机选取20例行无痛人流术非吸毒患者为对照组。术前查人绒毛膜促性腺激素（HCG ）均为阳性；B超确诊宫内妊娠。禁食禁饮4～6 h。入室后取截石位，两组患者均连接BIS监测仪于正确的位置，并连接丙泊酚TCI泵，起始血浆靶控浓度均为4μg/mL ，根据BIS值和血流动力学以及患者体动，以每次0．3～0．5μg/mL调整靶控浓度。待BIS维持在45～60之间，睫毛反射消失/钳夹宫口无体动，开始手术。并记录麻醉前（T0）、睫毛反射消失/钳夹宫口无体动（T1）、扩开宫口后开始清宫（T2）、术毕（T3）、麻醉苏醒时（T4）的平均动脉压（MBP）、心率（HR）、血氧饱和度（SpO2）以及BIS。术后查看丙泊酚 TCI泵，记录患者丙泊酚的总用量以及维持血浆靶控浓度。记录体动例数、呼吸抑制例数、手术时间以及苏醒时间。【结果】在相同的BIS值麻醉深度下，试验组的丙泊酚的用量为（179±51）mg明显大于对照组（124±27）mg ；而苏醒时间明显小于对照组，且两组相比较差异有显著性（3．2±2．1vs4．3±1．9，P ＜0．05），两组手术时间、患者体动次数、呼吸抑制例数相比较差异无显著性（ P＞0．05）。【结论】单纯丙泊酚麻醉无痛人流术中，吸毒患者术中维持血浆靶控浓度约为（6．8±1．4）μg/mL。丙泊酚的用量显著大于非吸毒患者，而苏醒时间明显短于非吸毒患者。

Role of Bispectral Index for Guiding Propofol Dosage in Drug Abuse Patients Undergoing Painless Induced A-bortion

Objective To monitor bispectral index （BIS） of drug abuse patients undergoing painless induced abortion in order to find proper propofol dosage for drug abuse patients .Methods]A total of 20 drug abuse patients undergoing painless induced abortion in our hospital from 2009 to 2013 were randomly selected as experiment group ,while 20 non-drug abuse patients undergoing painless induced abortion were selected as control group .Human chorionic gonadotropin（HCG） was positive before the operation .Intrauterine pregnancy was confirmed by B-ultrasound .All patients were fast for 4 to 6 hours before the procedure .After positioned in lithotomy position ,BIS monitoring apparatus was connected to correct position and propofol TCI pump .The initial target-controlled concentration in plasma was 4μg/mL and regulated by BIS value ,hemodynamics and body movement of patients with 0 .3～0 .5μg/mL per time .When BIS maintained 45 to 60 ,eyeash reflex disappeared and no body movement after forceps clip for uterus was found ,the operation began .The mean arterial pressure（MBP） ,heart rate（HR） , SpO2 and BIS before anesthesia（T0 ） ,when eyeash reflex disappearance/no body movement after forceps clip（T1 ） ,at the be-ginning of curettage after uterine dilation（T2 ） ,after operation（T3 ） and at anesthesia recovery （T4） were recorded .Propofol TCI pump was checked after the operation .Total propofol dosage and maintenance plasma target-controlled concentration were recorded .The number of body movement ,respiratory depression ,operation time and recovery time were also recorded .Results]Under the anesthesia depth with the same value of BIS ,there was significant significance between two groups （ P 〈0 .05） .The propofol dosage in experiment group was （179 ± 51）mg ,which was obviously higher than that in control group （124 ± 27）mg] .The recovery time in experiment group was obviously shorter than that in control group ,and there was sig-nificant difference（ P 〈0 .05） .There was