摘要
目的在丙泊酚靶控输注(TCI)镇静的老年患者,评价大脑状态指数(CSI)在无手术刺激条件下监测镇静深度的准确性及年龄的影响。方法ASAⅠ～Ⅲ级患者40例,按年龄分为老年组(E组),年龄65～79岁;中青年组(Y组),年龄20～55岁,每组20例。所行手术不限,诱导插管前均予以丙泊酚TCI镇静,直至改良清醒/镇静评分(OAA/S)为0分后5min停止,每20秒作改良OAA/S,记录CSI和TCI系统预测效应部位浓度值(CE)每变化0.1μg/ml时的数值及时间。计算在丧失语言反应及意识消失时的CE的CE05、CE50、CE95以及CSI05、CSI50、CSI95。结果随着丙泊酚预测效应部位浓度增加,两组CSI逐渐降低,并与OAA/S有较好的相关性,两组比较差异无统计学意义。当OAA/S≤3分时,E组的CSI明显高于Y组(P<0.05)。结论CSI与预测效应部位浓度、改良OAA/S呈高度相关性,可以较好地监测老年人与中青年人的镇静深度,在相同意识状态下,老年人的预测效应室浓度要低于中青年人,其CSI高于中青年人。
Objective To investigate the effectiveness of cerebral state index（CSI）used to measure depth of sedation during target-controll infusion（TCI）of propofol in the elderly. Methods Forty ASA class Ⅰ-Ⅱ patients undergoing general anesthesia were divided into group E（65 to 79 years old ） and group Y（20 to 55 years old） with 20 patients each . The sedation level was assessed using modified OAA/S scale. Anesthesia was not induced with TCI of propofol until 5 min after the patients did not respond to pain stimulation（OAA/S= 0）. Modified OAA/S score was recorded every 20 seconds. The values of CE05, CE50, CE95 and CSI05, CSI50, CSI95 at loss of verbal contact（LVC） （modified OAA/S= 2） and loss of consciousness （LOC） （modified OAA/S= 2） were also calculated. Results CSI was correlated well with sedation depth . When the modelled OAA/S scale was lower than 3, the CSI values in group E were significantly higher than those in group Y （P〈 0.05）. Conclusion During TCI of propofol,CSI can be used to measure sedation depth accurately in two age groups. CSI was correlated well with CE and modified OAA/S. At the same OAA/S scale, the target effect-site concentration in the elderly was obviously lower than that in the youth. However, CSI values in the elderly were significantly higher than those in the youth during TCI of propofol.
出处
《临床麻醉学杂志》
CAS
CSCD
2007年第10期803-805,共3页
Journal of Clinical Anesthesiology
关键词
老年人
镇静
大脑状态指数
丙泊酚
Geriatrics
Sedation
Cerebral state index
Propofol
