标题：术中保温对老年患者全麻BIS恢复时间及苏醒期丙泊酚效应室浓度的影响

      作者：张春丽，徐志新    (海南医学院第二附属医院麻醉科，海南 海口 570311)

      卷次： 2017年28卷15期

      【摘要】 目的 评估术中保温对老年患者全麻脑电双频指数(BIS)恢复时间及苏醒期丙泊酚效应室浓度的影响。方法 选择海南医学院第二附属医院在2015年1月到2016年8月收治的全身麻醉下行胃肠外科手术老年患者62例，采用随机数表法将其分为观察组(n=31)和对照组(n=31)，观察组给予术中保温护理措施，对照组给予常规护理措施，比较两组在麻醉前(T0)、麻醉后1 h (T1)及2 h (T2)和手术结束时(T3)的食管的温度和平均动脉压(MAP)变化情况，同时比较两组停药至BIS≥80的时间及BIS≥80时丙泊酚效应室的浓度。结果 观察组在T1、T2和T3时相时，食管的温度及MAP均显著高于对照组，两组比较差异有统计学意义(P<0.05)，观察组食管温度和MAP在术前、术中和术后差异无统计学意义(P>0.05)，而对照组食管温度和MAP在术中和术后均显著低于术前，差异均有统计学意义(P<0.05)，两组停药时的BIS值差异无统计学意义(P>0.05)，观察组停药到BIS≥80所需时间显著短于对照组，且BIS≥80时丙泊酚效应室浓度显著高于对照组，差异均有统计学意义(P<0.05)。结论 对于老年全麻术者而言，术中保温措施有助于缩短患者BIS的恢复时间，并有利于苏醒期丙泊酚效应室浓度的降低，值得在临床中推广应用。
      【关键词】 胃肠肿瘤；麻醉；全身；保温；丙泊酚；老年人
      【中图分类号】 R614.2 【文献标识码】 A 【文章编号】 1003—6350（2017）15—2462—03

Effect of intraoperative warming on bispectral index recovery time and effect compartment concentration ofpropofol in elderly patients under general anesthesia.
ZHANG Chun-li, XU Zhi-xin. Department of Anesthesiology, theSecond Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan, CHINA
【Abstract】 Objective To evaluate the effect of intraoperative warming on the recovery time of EEG andbispectral index (BIS) and effect compartment concentration of propofol in elderly patients under general anesthesia.Methods We chose 62 elderly patients undergoing general anesthesia for gastrointestinal surgery between January2015 and August 2016. The patients were divided into observation group and control group by random number table,with 31 patients in each group. The observation group was given intraoperative warming measures, and the control groupwas given routine nursing measures. Before anesthesia (T0), 1 h (T1) and 2 h (T2) after anesthesia, and at the end of theoperation (T3), esophageal temperature, mean arterial pressure (MAP) changes, duration from drug withdrawal to BIS≥80, and effect compartment concentration of propofol at BIS≥80 were compared between the two groups. Results Theesophageal temperature and MAP were significantly higher in the observation group than those in the control group atT1, T2 and T3 (P<0.05), but they showed no significant difference between the two groups before, during, and after oper-ation (P>0.05). In the control group, the esophageal temperature and MAP during and after operation were significantlylower than those before operation (P<0.05). The difference in BIS at drug withdrawal between the two groups was statis-tically significant (P>0.05). The duration from drug withdrawal to BIS≥80 in the observation group was significantlyshorter than that of the control group, and effect compartment concentration of propofol was significantly higher thanthat of the control group at BIS≥80 (P<0.05). Conclusion For elderly patients with general anesthesia, intraoperativewarming measures can help to shorten the BIS recovery time of patients, and is conducive to the decrease of the effectcompartment concentration of propofol, which is worth to be promoted.
      【Key words】 Gastrointestinal neoplasms; Anesthesia; General; Warming; Propofol; Elderly·论 著·doi:10.3969/j.issn.1003-6350.2017.15.015