The Association of BIS and HRV in TargetControlled Infusion of Etomidate Used in Fasttracking Anesthesia of the Elderly_West China Medical Journal

Authors：

1Department of Anesthesiology, West City of Bazhong,Bazhong 635500,China;2Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu 610041,China;3Department of Anesthesiology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou, 450000,China;

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Keywords：

麻醉; 静脉; 心率变异性; 靶控输注; 快通道; 依托咪酯

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目的:研究老年患者依托咪酯靶控输注时不同BIS值(脑电双频指数)的HRV(心率变异性)的变化情况,探讨不同镇静深度与HRV之间的关系。方法:选择65岁以上行门诊胃镜检查患者30例,随机分为3组,A组BIS45~55,B组55~65,C组65~75,各组均在麻醉前、麻醉诱导后,术中、术毕监测BIS、HRV及血液动力学指标。结果:A组各监测HRV明显降低(P lt;0.05),B组仅有轻度下降(P gt;0.05),C组明显升高(P lt;0.05)。结论:患者镇静深度BIS55~65时,即可明显抑制内镜操作刺激所致的HRV变化,是临床较为合适的镇静深度,可显著降低老年患者交感神经活性、交感/迷走神经均衡性和自主神经总张力,利于机体血液动力学稳定。

Citation： MA Youbing,LIN Yanjun,WANG Hongwei.. The Association of BIS and HRV in TargetControlled Infusion of Etomidate Used in Fasttracking Anesthesia of the Elderly. West China Medical Journal, 2009, 24(9): 2295-2297. doi: Copy

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1. BERGEN JM, SMITH DC. A review of etomidate for rapid sequence intubation in the emergency department[J]. J Emerg Med, 1997, 15(2): 221-230.
2. GEPTS E. Pharmacokinetic concepts for TCI anaesthesia[J]. Anaesthesia, 1998, 53 Suppl 1: 4-12.
3. MARCIANI RD. Critical systemic and psychosocial considerations in management of trauma in the elderly[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1999, 87(3): 272-280.
4. 徐建设, 陈恒星, 陈辉, 刘高望, 谭琳玲. 依托咪酯对高龄和休克病人全麻诱导血液动力学的影响[J]. 第一军医大学学报, 2005, (08): 1060-1061.
5. KAZAMA T, TAKEUCHI K, IKEDA K, et al. Optimal propofol plasma concentration during upper gastrointestinal endoscopy in young, middleaged, and elderly patients[J]. Anesthesiology, 2000, 93(3): 662-669.
6. SARKAR M, LAUSSEN PC, ZURAKOWSKI D, SHUKLA A, KUSSMAN B, ODEGARD KC. Hemodynamic responses to etomidate on induction of anesthesia in pediatric patients[J]. Anesth Analg, 2005, 101(3): 645-650.
7. LALLEMAND MA, LENTSCHENER C, MAZOIT JX, BONNICHON P, MANCEAU I, OZIER Y. Bispectral index changes following etomidate induction of general anaesthesia and orotracheal intubation[J]. Br J Anaesth, 2003, 91(3): 341-346.
8. PUNJASAWADWONG Y, BOONJEUNGMONKOL N, PHONGCHIEWBOON A. Bispectral index for improving anaesthetic delivery and postoperative recovery[J]. Cochrane Database Syst Rev, 2007, (4): CD003843.
9. BERKENBOSCH JW, FICHTER CR, TOBIAS JD. The correlation of the bispectral index monitor with clinical sedation scores during mechanical ventilation in the pediatric intensive care unit[J]. Anesth Analg, 2002, 94(3): 506-511.
10. 曾辉, 蔡静怡, 王静, 郭小玉, 杨阳, 李方洁. 不同年龄和性别短程心率变异性对比分析[J]. 临床心电学杂志, 2008, (02): 108-110.
11. 邱勇玉, 刘海妹, 包小英. 不同年龄段健康人心率变异性分析[J]. 卫生职业教育, 2008, (12): 140-141.

West China Medical Journal

The Association of BIS and HRV in TargetControlled Infusion of Etomidate Used in Fasttracking Anesthesia of the Elderly

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