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目的观察丙泊酚闭环靶控输注以脑电双频指数(BIS)作为反馈指标在胃肠道肿瘤手术中的应用。方法拟在全凭静脉麻醉下进行胃肠道肿瘤手术的患者40例随机分为对照组(开环靶控组)20例与试验组(闭环靶控组)20例,观察2组患者在诱导前(T_0)、意识消失(T_1)、气管导管插入成功即刻(T_2)、气管插管成功后1 min(T_3)、切皮(T_4)、术中探查(T_5)、关闭腹膜(T_6)的平均动脉压(MAP)、心率(HR)、脑电双频指数(BIS)值、靶控泵调节频率、麻醉恢复情况等,并记录不良反应发生情况。结果与T_0比较,2组在T_1~T_6 MAP、BIS值均明显降低(P<0.05),HR在T_1,T_6明显降低(P<0.05)。对照组在T_4,T_5 MAP升高较试验组显著(P<0.05),对照组在T_2,T_3,T_4,T_5 BIS值升高较试验组显著(P<0.05)。在靶控泵平均调节频率方面,试验组显著高于对照组(P<0.05)。麻醉结束后试验组的苏醒时间、拔管时间、定向力恢复时间较对照组明显缩短(P<0.05)。2组在术后恶心、呕吐、寒战及术中知晓发生率差异无统计学意义(P>0.05)。结论 BIS闭环靶控输注系统优于开环靶控输注,能使血流动力学及BIS值更加稳定,维持合理的麻醉深度,使术后麻醉苏醒与恢复更快。
Objective To observe the application of closed-loop target-controlled infusion of propofol in gastrointestinal cancer surgery with the use of bispectral index (BIS) as a feedback indicator. Methods Totally 40 patients undergoing total gastrointestinal surgery under intravenous anesthesia were randomly divided into control group (open-loop target-controlled group) and experimental group (closed-loop target-controlled group) (T_0), disappearance of consciousness (T_1), success of tracheal catheterization (T_2), tracheal intubation success 1 min (T_3), incision (T_4), intraoperative exploration (T_5) Mean arterial pressure (MAP), heart rate (HR), bispectral index (BIS), target control pump adjustment frequency, recovery of anesthesia, etc., and record the occurrence of adverse reactions. Results Compared with T 0, the T 2 and T 6 MAP and BIS values were significantly decreased in both groups (P <0.05), while HR decreased at T 1 and T 6 (P <0.05). The increase of T_4 and T_5 MAP in the control group was significantly higher than that in the test group (P <0.05). The BIS value of T_2, T_3, T_4 and T_5 in the control group was significantly higher than that in the test group (P <0.05). The experimental group was significantly higher than the control group (P <0.05). After anesthesia, the recovery time, extubation time and recovery time of the force in the experimental group were significantly shorter than those in the control group (P <0.05). Nausea, vomiting, chills and intraoperative awareness of the incidence of postoperative nosignificant difference was not statistically significant (P> 0.05). Conclusion BIS closed-loop target-controlled infusion system is better than open-loop target-controlled infusion, which can make hemodynamics and BIS value more stable, maintain a reasonable depth of anesthesia and make anesthesia wake up and recover faster.