磷酸肌酸钠对老年患者全麻恢复期BIS值和苏醒质量的影响

目的观察磷酸肌酸钠对老年患者全麻恢复期BIS值和苏醒质量的影响。方法选择择期全麻下行经腹胆囊切除术患者60例,男31例,女29例,年龄65~80岁,ASAⅠ或Ⅱ级,按照计算机产生的随机数字将患者分为两组,每组30例。P组在切皮时开始静脉输注磷酸肌酸钠1.0g(溶于100ml生理盐水),输注时间30min,C组静脉输注相同容量的生理盐水。记录诱导前(T0)、吸痰时(T_1)、拔管时(T_2)、拔管后1min(T_3)、5min(T_4)、10min(T_5)、15min(T_6)的HR和BIS值,T_3~T_6的Steward苏醒评分;记录患者麻醉时间、手术时间、清醒时间、拔管时间、意识恢复时间和丙泊酚、瑞芬太尼、顺苯阿曲库铵用量,并观察术中心动过速发生情况。结果与T0时比较,T_1~T_4时两组患者BIS值明显降低,HR明显增快(P0.05);T_1~T_4时P组BIS值明显高于C组(P0.05);P组清醒时间、拔管时间、意识恢复时间明显短于C组(P0.05);C组患者术中有6例发生心动过速,P组有2例,C组术中心动过速发生率明显高于P组(P0.05);T_3、T_4时P组Steward苏醒评分明显高于C组(P0.05)。结论术中静脉输注1.0g磷酸肌酸钠可明显提高经腹胆囊切除术的老年患者全麻恢复期BIS值及苏醒质量,且可降低术中心动过速的发生率。

Effect of creatine phosphate sodium on bispectral index and recovery quality during general anesthesia e-mergence period in elderly patients

Objective To observe the effect of creatine phosphate sodium on BIS and recovery quality during general anesthesia emergence period in elderly patients.Methods Sixty ASA Ⅰ or Ⅱpatients,31 males,29 females,aged 65-80 yr undergoing transabdominal cholecystectomy by general anesthesia were randomly allocated into two groups(n=30 each):group creatine phosphate (P)and group control(C)according to random numbers generated by computer.Patients were intravenously infused with 1.0 g creatine phosphate sodium melted in 100 ml normal saline or only 100 ml normal saline in group P or C respectively in thirty minutes at the same time of surgical incision.The heart rate(HR)and bispectral index(BIS)were recorded before anesthesia induction (T0 ),during sputum aspiration (T0 ),during extubation (T2 )and 1(T3 ),5(T4 ),10(T5 ),15 minutes (T6 )after extubation. The dosage of propofol,remifentanil and cisatracurium,anesthesia duration,operation time,awake time,extubation time,recovery time of consciousness and Steward recovery scores on T3-T6 were also recorded,and the occurrence of tachycardia during the operation was observed at the same time. Results Compared with T0 ,the BIS value were lower significantly and HR were significantly in-creased on T1-T4 in the two groups(P <0.05).Compared with group C,the BIS value were signifi-cantly higher in group P on T1-T4 (P <0.05).Compared with group C,awake time,extubation time, recovery time of consciousness significantly shortened in group P (P <0.05).There were six cases of tachycardia occurring in group C which were significantly higher than two cases in group P (P <0.05).Steward recovery scores on T3 and T4 were also higher in group P (P <0.05).Conclusion Not only can 1.0 g creatine phosphate sodium administered during transabdominal cholecystectomy im-prove the BIS value of general anesthesia recovery period and recovery quality,but also effectively re-duce the incidence rate of tachycardia during operation in elderly patients.