| 引用本文: | 朱广球,杨灵君,尤匡掌.昼夜节律对丙泊酚麻醉深度的影响[J].中国现代应用药学,2013,30(11):1239-1242. |
| ZHU Guangqiu,YANG Lingjun,YOU Kuangzhang.Influence of Circadian Rhythm on Depth of Propofol Anesthesia[J].Chin J Mod Appl Pharm(中国现代应用药学),2013,30(11):1239-1242. |
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| 摘要: |
| 目的 研究昼夜节律对丙泊酚全麻诱导时麻醉深度的影响。方法 选择白天组(8：00~12：00)和夜间组(22：00~2：00)全麻手术患者各30例，年龄20~45岁，ASA I级，无睡眠障碍。丙泊酚靶控效应室浓度自1.0 μg·mL-1开始，每次增加0.5 μg·mL-1直至3.0 μg·mL-1。静注咪唑安定0.05 mg·kg-1、芬太尼5 μg·kg-1、顺式阿曲库铵0.15 mg·kg-1，3 min后行气管插。依次记录靶控输注前(T0)及各效应室浓度平衡2 min后(T1：1.0 μg·mL-1、T2：1.5 μg·mL-1、T3：2.0·mL-1、T4：2.5 μg·mL-1、T5：3.0 μg·mL-1)及插管前(T6)各时点的BIS值、平均动脉压、心率。结果 夜间组患者在T3、T4、T5、T6时其BIS值明显低于白天组患者(P<0.05)。在诱导期间平均动脉压和心率随麻醉的加深而降低，组间差异均无统计学意义(P>0.05)。结论 昼夜节律对丙泊酚麻醉深度有明显的影响，相同效应室浓度下夜间镇静程度比白天深。 |
| 关键词: 昼夜节律 丙泊酚 麻醉深度 脑电双频指数 |
| DOI： |
| 分类号:RR614 |
| 基金项目: |
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| Influence of Circadian Rhythm on Depth of Propofol Anesthesia |
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ZHU Guangqiu, YANG Lingjun, YOU Kuangzhang
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Department of Anaesthesiology, Taizhou Hospital of Zhejiang Province, Linhai 317000, China
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| Abstract: |
| OBJECTIVE To investigate the influence of circadian rhythm on anesthesia depth of propofol. METHODS Patients undergoing general anesthesia within 8：00~12：00 or 22：00~2：00 were chosen as day group and night group (n=30 each group). All the patients aged 20~45 years without sleep disorder. Anesthesia was induced with propofol delivered by target controlled infusion(TCI). The initial effect-site concentration of propofol was set at 1.0 μg·mL-1, and increased step-by-step with 0.5 μg·mL-1 after having balanced for 2 min until reached 3.0 μg·mL-1. And then patients were injected with midazolum 0.05 mg·kg-1, fentanyl 5 μg·kg-1 and cisatracurium 0.15 mg·kg-1 by intravenous before tracheal intubation. The bispectral index(BIS), MAP and HR values were recorded before propofol infused(T0), at each effect-site concentration of propofol (T1: 1.0 μg·mL-1; T2: 1.5 μg·mL-1; T3: 2.0 μg·mL-1; T4: 2.5 μg·mL-1; T5: 3.0 μg·mL-1) and before tracheal intubation(T6). RESULTS The BIS values were significantly lower at T3, T4, T5 and T6 in night group compared with day group(P<0.05). The MAP and HR were gradually decreased when induction, but without significant difference between the two groups(P>0.05). CONCLUSION Circadian rhythm may have remarkable effect on the depth of propofol anesthesia, and it is more potent when administered at night. |
| Key words: circadian rhythm propofol depth of anesthesia bispectral index |
