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目的 :探讨老年患者胃癌根治术丙泊酚靶控浓度与脑电双频指数变化的关系。方法 :老年患者胃癌根治术患者120例根据随机数字表法分为治疗组与对照组各60例,所有患者都选择气管插管丙泊酚靶控麻醉,治疗组的靶浓度从0.5μg/m L开始逐级递增,递增梯度为0.5μg/m L;对照组靶浓度从2.0μg/m L开始逐级递增,递增梯度为1.0μg/m L。两组患者都记录了清醒状态时、意识消失时、插管前、插管后1min、插管后3min的脑电双频指数(BIS)、平均动脉压(MAP)和心率(HR)。观察与记录两组患者的丙泊酚效应室浓度与意识消失时丙泊酚诱导总量。结果 :治疗组与对照组的丙泊酚效应室浓度分别为3.14±0.12μg/m L和3.14±0.15μg/m L。治疗组的丙泊酚诱导总量分别为224.84±70.84mg,对照组为248.54±62.01mg,治疗组的丙泊酚诱导总量明显少于对照组。麻醉期间两组的MAP与HR值都呈现明显降低的趋势,不过治疗组插管不同时间点MAP与HR值都高于对照组。两组清醒状态时的BIS值都明显高于其他监测点,而对照组由于丙泊酚用量的增加,BIS下降的幅度更大,组间对比差异都也有统计学意义。结论 :BIS可准确地反应丙泊酚的镇静深度,低剂量丙泊酚靶控输注能有有效保持BIS值稳定与血流动力学稳定,减少丙泊酚诱导总量,保障老年患者胃癌根治术的安全。
Objective : To investigate the relationship between the target concentration of propofol and the bispectral index of electroencephalography in elderly patients with radical gastrectomy. Methods: A total of 120 elderly patients with radical gastrectomy were randomly divided into treatment group and control group according to random number table method. Each patient selected tracheal intubation with propofol target anesthesia. The target concentration of the treatment group was 0.5 μg/m. L gradually increased progressively, with an increasing gradient of 0.5 μg/m L; the control group’s target concentration increased gradually from 2.0 μg/m L, and the incremental gradient was 1.0 μg/m L. Both groups recorded bispectral bispectral index (BIS), mean arterial pressure (MAP), and heart rate (HR) during wakefulness, loss of consciousness, preintubation, 1 min after intubation, and 3 min after intubation. Observe and record the propofol concentration in the two groups of patients and the total induction of propofol when consciousness disappears. Results : The propofol concentration in the treatment group and the control group were 3.14±0.12μg/m L and 3.14±0.15μg/m L, respectively. The total amount of propofol induction was 224.84±70.84 mg in the treatment group and 248.54±62.01 mg in the control group. The total amount of propofol induction in the treatment group was significantly lower than that in the control group. During the anesthesia, the MAP and HR values of both groups showed a tendency to decrease. However, the MAP and HR values in the treatment group at different time points were higher than those in the control group. The BIS values in both groups were significantly higher than those of other monitoring points in the awake state, while the BIS decreased more in the control group due to the increase in the use of propofol, and the difference between the two groups was also statistically significant. Conclusion: BIS can accurately reflect the sedation depth of propofol. Low-dose propofol target controlled infusion can effectively maintain the stability of BIS value and hemodynamic stability, reduce the total induction of propofol, and ensure the cure of gastric cancer in elderly patients. The safety of surgery.