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目的 :观察心率变异性 (HRV)在咪唑安定、异丙酚及其复合镇静时的变化。方法 :选择ASAⅠ～Ⅱ级 ,在下胸腰段硬膜外阻滞下择期手术的成年病人 6 0例 ,随机分为四组 ,每组 15例 ,Ⅰ组为咪唑安定组 ,Ⅱ组为咪唑安定0 0 2 5mg/kg加异丙酚组 ,Ⅲ组为咪唑安定 0 0 5mg/kg加异丙酚组 ,Ⅳ组为异丙酚组。Ⅰ组、Ⅳ组每间隔 2～ 3分钟静注咪唑安定 1 5mg或异丙酚 2 0mg ;Ⅱ组、Ⅲ组先静注咪唑安定 0 0 2 5mg/kg或 0 0 5mg/kg ,4分钟后每间隔 2～ 3分钟给病人静注异丙酚 2 0mg ,直至警觉 /镇静评分值达到 1分。观察记录病人不同OAA/S评分值及评分值达到 1分后 5分钟时HRV、BP、HR和SpO2 的变化。结果 :各组病人HRV各成分均随镇静程度改变而变化。单纯咪唑安定、0 0 2 5mg/kg咪唑安定复合异丙酚、0 0 5mg/kg咪唑安定复合异丙酚组病人对LF、TP抑制较明显 ;单纯异丙酚组病人中HF抑制较为显著 ,复合用药组病人对HF抑制作用介于咪唑安定与异丙酚之间。结论 :对病人HRV功率谱分析可动态反映咪唑安定、异丙酚及其复合镇静时病人自主神经的不同变化
Objective: To observe the changes of heart rate variability (HRV) during the sedation of midazolam and propofol. Methods: Sixty adult patients undergoing ASA Ⅰ ~ Ⅱ under elective thoracolumbar epidural block were randomly divided into four groups (n = 15 each). Group Ⅰ was midazolam, while group Ⅱ was midazolam 0 0 2 5mg / kg plus propofol group, Ⅲ group was midazolam 0 0 5mg / kg plus propofol group, Ⅳ group was propofol group. Groups Ⅰ and Ⅳ were treated with midazolam 15 mg or propofol 20 mg every 2 to 3 minutes. Groups Ⅱ and Ⅲ were treated with midazolam 0 0 2 5 mg / kg or 0 5 mg / kg intravenously 4 minutes later Patients were intravenously infused with propofol 20 mg every 2 to 3 minutes until the alert / sedation score reached 1 point. The changes of HRV, BP, HR and SpO2 were recorded and recorded after different OAA / S scores and score of 1 minute and 5 minutes respectively. Results: The HRV components in all groups changed with the change of sedation. Simple midazolam, 0 025mg / kg midazolam propofol, 0 0 5mg / kg midazolam combined with propofol group of patients with LF, TP inhibition was more obvious; simple propofol group of patients with HF inhibition was significant, The composite drug group patients inhibit HF between midazolam and propofol. Conclusion: The HRV power spectrum analysis of patients can dynamically reflect the different changes of midazolam, propofol and their compound sedation in patients with autonomic nervous system