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山东大学学报(医学版)

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状态熵指数与靶控输注异丙酚时镇静深度及预测效应部位浓度的关系

王振元,李明颖,李洁,于金辉,张晓霞,孙晓黎   

  1. 首都医科大学附属北京朝阳医院京西院区麻醉科, 北京 100043
  • 收稿日期:2007-04-30 修回日期:1900-01-01 出版日期:2007-08-24 发布日期:2007-08-24
  • 通讯作者: 王振元

Relationship between state entropy and predicted effect-site propofol concentration at different clinical endpoints

WANG Zhen-yuan, LI Ming-ying, LI Jie, YU Jin-hui, ZHANG Xiao-xia, SUN Xiao-li   

  1. Department of Anesthesiology, West Campus of Beijing Chaoyang Hospital, Capital University of Medical Sciences, Beijing 100043, China
  • Received:2007-04-30 Revised:1900-01-01 Online:2007-08-24 Published:2007-08-24
  • Contact: WANG Zhen-yuan

摘要: 目的:探讨状态熵指数(SE)与靶控输注异丙酚麻醉不同镇静深度及预测效应部位浓度的关系,并与BIS进行比较。方法:择期全麻患者20例,靶控输注异丙酚初始靶浓度为1.0μg/ml,预测效应部位浓度达到设定浓度后1min以0.5μg/ml的浓度梯度递增,目标镇静深度为警觉/镇静(OAA/S)评分1分。结果:SE、BIS与OAA/S评分相关系数分别为0.82(P<0.01)和0.73(P<0.01); SE、BIS与预测效应部位浓度之间相关系数分别为-0.66(P<0.01)和-0.70(P<0.01),50%和90%患者意识消失时的预测效应部位浓度分别为3.55(3.17,4.61)μg/ml和4.83(4.07,7.00)μg/ml。结论:状态熵指数与靶控输注异丙酚时的不同镇静深度以及预测效应部位药物浓度具有良好的相关性。

Abstract: Objective: To investigate the relationship between state entropy (SE) and predicted effect-site propofol concentration and the accuracy for predicting different clinical endpoints. Methods: Twenty unpremedicated patients undergoing elective surgery with general anesthesia received a target-controlled infusion of propofol. The initial effect-site concentration of propofol was set at 1.0 μg/ml, and increased by 0.5 μg/ml at 1 min after having obtained a specific target concentration. The depth of sedationanesthesia was assessed by using the Observer′s Assessment of Alertness/Sedation (OAA/S) rating scale. The target sedation level of induction was defined as OAA/S score at 1. Results: With the increase of sedation, there was a progressive decrease of SE and BIS values. SE(r= 0.82, P<0.01) and BIS(r=0.73, P<0.01) positively correlated with OAA/S, while SE(r=-0.66, P<0.01) and BIS(r=-0.70, P<0.01 ) negatively correlated with the predicted effect-site propofol concentration. The predicted effect-site propofol concentration for 50% and 90% patients at loss of consciousness was 3.55(3.17,4.61)μg/ml and 4.83(4.07,7.00)μg/ml. Conclusion: Compared with BIS, SE has the same good correlation with the effect-site concentration and it is useful in predicting the different clinical endpoints.

Key words: Propofol, Bispectralindex, entropy, Electroencephalography, Drug delivery system, Anesthesia, intravenous

中图分类号: 

  • R826.24
[1] 王子申,类维富 . 小剂量多巴胺于腰硬联合麻醉下剖宫产手术中的应用[J]. 山东大学学报(医学版), 2007, 45(7): 755-756.
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