老年患者匀速注射丙泊酚的量效关系及其对痛阈的影响.pdf
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老年患者匀速注射丙泊酚的量效关系及其对
痛阈的影响
杨跃武 忻纪华 周密 郑青山 王祥瑞 孙大金
.I临床
【摘要】 目的 观察在不同剂量丙泊酚镇静下老年患者BIs、MAP及HR的变化趋势及其对痛
阈的影响。方法选择年龄65～89岁，ASA I或Ⅱ级。行择期手术的患者40例，随机均分为四组，分别接受4个不同剂量的丙泊酚匀速静脉注射。即I组o.75 mg/kg、Ⅱ组1 mg/kg、Ⅲ组1.25
mg/kg、Ⅳ组1.5 mg/kg，注射时间均为1 min。改良警觉/镇静(oAA/S)评分法测各组丙泊酚镇静催
眠深度。微电流致痛法测各组痛阈。分别于注药前、注药后1min测四组BIS、HR、MAP及痛阈低
值和高值。结果 注药后1min.I、Ⅱ组0AA/s评分均达到2或1分，Ⅲ、Ⅳ组。分。I、Ⅱ组BlS
值分别是70.4士12.3、68.7士6.4，Ⅲ、Ⅳ组的Bls是56.3士13.3及48.3土9.8，其中注药后1 min
Ⅲ、Ⅳ组的BIS值分别显著低于I、Ⅱ组(P
负相关(r=一O.648，P
O.01)。注药后1min，四组的MAP均显著低于注药前(P
I、Ⅱ组(P
Ⅲ、Ⅳ组的痛阈低值高于注药前，也高于同时点的I、Ⅱ组(P
显著高于注药前(P
呈线性负相关。1.25、1.5 mg/kg的丙泊酚单次匀速静注后可满足老人全麻术中镇静催眠的需求，并
使痛阈水平上升，疼痛敏感性降低。
【关键词】 丙泊酚；镇静；脑电双频指数；痛阈
TIle d懈·eH赴t他lat萱onship ofpropofolinfusion柚d№effect蚰pain曲馏hoM ineIderly patienb
YANG Yue-wu，xIN J}.h她，zHoU Mt，et n1.De∞rtmmt 0f Anest沁stotogy，Ren{l Hospit4t，^缸di∞Z coZfe护o，S妇Hg妇f.，f口DfD，lg U耐w捌f_)，，跏口愕lIl4f 200 1 27，China
【Abstnct】 objective To observe the changes of BlS，MAP，HR and pain threshold induced by
different doses of propofol in elderly patients.Methods I、orty elder patients(65—89 years old)，ASA
class I orⅡ，scheduled for selective surgeries，were divided randomly and equally into 4different
doses of propofol(constant intravenous injection for 1min)groups of O.75 mg/kg(I)，1 mg/kg
(Ⅱ)，1.25 mg/kg(Ⅲ)and 1.5 mg/kg(Ⅳ).Responsiveness’s OAA/S scores were used for judging
sedation and hypnosis degree.亡虻rect current potassium phoresis was used for detecting pain
threshold.BIS， HR，MAP，low pain threshold and high pain threshold were monitored before
propofolinjection and at1min after propofolinjection.R巧uIts 1min after propofolinjection，0AA/
S scores in group I andⅡwere 2or1，which in groupⅢandⅣwere O.Data of BIS in group I
andⅡwere 70.4士12.3，68.7士6.4，and ingroupⅢandⅣwere 56.3士13.3，48.3士9.8，respectively. BIS values ingroup Ⅲ andⅣ were significantly lower than those ingroup Iand Ⅱ
(P
O.01)，BlS=96.626—31.719×dose of propofol(，=O.419，P
At 1min after propofolinjection.MAP decreased remarkably compared with at before in all 4 groups
(P
O.05).At lmin after propofQlinjection，the low pain threshold was higher ingroupⅢor groupⅣ
(P<0.01 or P
老年患者匀速注射丙泊酚的量效关系及其对
痛阈的影响
杨跃武 忻纪华 周密 郑青山 王祥瑞 孙大金
.I临床
【摘要】 目的 观察在不同剂量丙泊酚镇静下老年患者BIs、MAP及HR的变化趋势及其对痛
阈的影响。方法选择年龄65～89岁，ASA I或Ⅱ级。行择期手术的患者40例，随机均分为四组，分别接受4个不同剂量的丙泊酚匀速静脉注射。即I组o.75 mg/kg、Ⅱ组1 mg/kg、Ⅲ组1.25
mg/kg、Ⅳ组1.5 mg/kg，注射时间均为1 min。改良警觉/镇静(oAA/S)评分法测各组丙泊酚镇静催
眠深度。微电流致痛法测各组痛阈。分别于注药前、注药后1min测四组BIS、HR、MAP及痛阈低
值和高值。结果 注药后1min.I、Ⅱ组0AA/s评分均达到2或1分，Ⅲ、Ⅳ组。分。I、Ⅱ组BlS
值分别是70.4士12.3、68.7士6.4，Ⅲ、Ⅳ组的Bls是56.3士13.3及48.3土9.8，其中注药后1 min
Ⅲ、Ⅳ组的BIS值分别显著低于I、Ⅱ组(P
负相关(r=一O.648，P
O.01)。注药后1min，四组的MAP均显著低于注药前(P
I、Ⅱ组(P
Ⅲ、Ⅳ组的痛阈低值高于注药前，也高于同时点的I、Ⅱ组(P
显著高于注药前(P
呈线性负相关。1.25、1.5 mg/kg的丙泊酚单次匀速静注后可满足老人全麻术中镇静催眠的需求，并
使痛阈水平上升，疼痛敏感性降低。
【关键词】 丙泊酚；镇静；脑电双频指数；痛阈
TIle d懈·eH赴t他lat萱onship ofpropofolinfusion柚d№effect蚰pain曲馏hoM ineIderly patienb
YANG Yue-wu，xIN J}.h她，zHoU Mt，et n1.De∞rtmmt 0f Anest沁stotogy，Ren{l Hospit4t，^缸di∞Z coZfe护o，S妇Hg妇f.，f口DfD，lg U耐w捌f_)，，跏口愕lIl4f 200 1 27，China
【Abstnct】 objective To observe the changes of BlS，MAP，HR and pain threshold induced by
different doses of propofol in elderly patients.Methods I、orty elder patients(65—89 years old)，ASA
class I orⅡ，scheduled for selective surgeries，were divided randomly and equally into 4different
doses of propofol(constant intravenous injection for 1min)groups of O.75 mg/kg(I)，1 mg/kg
(Ⅱ)，1.25 mg/kg(Ⅲ)and 1.5 mg/kg(Ⅳ).Responsiveness’s OAA/S scores were used for judging
sedation and hypnosis degree.亡虻rect current potassium phoresis was used for detecting pain
threshold.BIS， HR，MAP，low pain threshold and high pain threshold were monitored before
propofolinjection and at1min after propofolinjection.R巧uIts 1min after propofolinjection，0AA/
S scores in group I andⅡwere 2or1，which in groupⅢandⅣwere O.Data of BIS in group I
andⅡwere 70.4士12.3，68.7士6.4，and ingroupⅢandⅣwere 56.3士13.3，48.3士9.8，respectively. BIS values ingroup Ⅲ andⅣ were significantly lower than those ingroup Iand Ⅱ
(P
O.01)，BlS=96.626—31.719×dose of propofol(，=O.419，P
At 1min after propofolinjection.MAP decreased remarkably compared with at before in all 4 groups
(P
O.05).At lmin after propofQlinjection，the low pain threshold was higher ingroupⅢor groupⅣ
(P<0.01 or P
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