摘要 目的: 观察异丙酚-芬太尼全静脉麻醉的临床应用效果。方法: 14例择期在气管插管全身麻醉下行腹部手术的患者,接受芬太尼总量8μg/kg静脉注射、异丙酚“目标控制性输注法”使脑电双频谱指数降至55～70。实验中分别观察麻醉诱导前(基础值)、气管插管前即刻、气管插管后2min、切皮前、手术操作期5个时相的麻醉效果,并观察平均动脉压(MAP)、心率(HR)、氧饱和度的改变。采用近红外线光谱仪监测脑氧合血红蛋白(HbO₂ )、还原血红蛋白(Hb)、全血红蛋白(THb)变化。结果: 异丙酚-芬太尼全静脉麻醉期间MAP维持稍偏低但平稳状态,HR改变不大，HbO₂ 、Hb及THb均有所下降。手术开始后,MAP和HR均呈一定程度升高。结论: 异丙酚-芬太尼全静脉麻醉时，手术应激反应仍存在，对脑氧合功能影响不大，脑血流有所降低，对血流动力学及脑氧合-脑血流动力学均无明显不利效应。

BISPECTRAL INDEX AND NEAR-INFRARED SPECTROSCOPY

    IN THE MONITORING OF TOTAL INTRAVENOUS PROPOFOL

    AND FENTANYL ANESTHESIA FOR ABDOMINAL SURGERY

Zhang Jinhua,Li Chenghui,Jia Naiguang,et al

    (Department of Anesthesiology)

Abstract Objective: To observe clinical effect of total intravenous anesthesia(TIVA) with propofol and fentanyl.Methods: In fourteen patients undergoing elective abdominal surgical operation with general anesthesia,the bispectral index(BIS) was decreased to 55-70 with the intravenous injection of fentanyl(a total dosage of 8 μg/kg) and infusion of propofol(target-controlled infusion).The changes in anesthetic results,mean arterial pressure(MAP),heart rate(HR),cerebral oxyhemoglobin(HbO₂ ),hemoglobin(Hb) and total Hb(with a near-infrared spectoscope) were observed respectively during the following periods:before anesthesia,before endotracheal intubation,two minutes after intubation,before skin incision and during operation.Results: During TIVA with propofol and fentanyl,reduced MAP with its well maintaining,little change of HR,and a little decreased cerebral HbO₂ ,Hb and total Hb were shown.But the MAP and HR was increased after initiation of operation.Conclusion: During TIVA with propofol and fentanyl,the surgical stress was still present.Although the cerebral blood flow was a little decreased,the cerebral oxygenation was well protected.It suggests that there was no significant side effects on the hemodynamics and cerebral oxygenation.

    Subject headings:anesthesia,intravenous;propofol;fentanyl;spectra,Fourier analysis infrared

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