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目的 利用OAA/S镇静评分法探讨异丙酚不同镇静程度下对循环呼吸的影响 ,并分析评价双频谱指数预测异丙酚镇静程度的作用。方法 2 0例ASA 1～ 2级下肢手术患者 ,硬膜外麻醉效果稳定后 ,静脉注射异丙酚 3 0mg后每隔 0 5～ 1min增加 10～ 2 0mg至OAA/S评分为 1时止 ,继续观察患者OAA/S评分回到 5。记录不同OAA/S评分时循环呼吸参数、双频谱指数 (BIS)和 95 %边缘谱频率 (SEF)。结果 异丙酚镇静起效期和恢复期 ,OAA/S评分与BIS和SEF均显著相关 (P <0 0 0 1)。OAA/S评分为 3时 ,心率呼吸减慢 ,血压下降 ,到 1时抑制最明显 ,同时呼气末二氧化碳分压增高。结论 临床应用BIS和SEF预测异丙酚镇静程度是可信的。异丙酚镇静时 ,应控制在OAA/S评分 3以上 ,即BIS和SEF分别为 80和 2 2以上 ,以免明显的循环呼吸抑制。
OBJECTIVE: To investigate the effect of propofol on circulatory respiration with different sedation levels by using OAA / S sedation score and to analyze and evaluate the effect of bispectral index on propofol sedation. Methods Twenty two patients with lower extremity ASA 1 ~ 2 underwent surgery. After the epidural anesthesia was stable, propofol 30 mg intravenously was added every 10 min to 20 min until the OAA / S score was 1, Continue to observe the patient’s OAA / S score back to 5. Circadian respiratory parameters, bispectral index (BIS) and 95% edge spectral frequency (SEF) were recorded for different OAA / S scores. Results The onset and recovery phases of propofol sedation were significantly correlated with BIS and SEF (P <0.01). OAA / S score of 3, heart rate breathing slowed down, blood pressure decreased to 1:00 the most obvious inhibition, while partial pressure of end-tidal carbon dioxide increased. Conclusions The clinical application of BIS and SEF to predict propofol sedation is credible. Propofol sedation, should be controlled in the OAA / S score 3 or more, that is, BIS and SEF were 80 and 22, respectively, in order to avoid significant inhibition of circulating respiratory.