国际麻醉学与复苏杂志   2015, Issue (3): 5-5
    
闭环靶控下不同麻醉镇静深度对患者围术期炎性反应的影响
王煜, 薛荣亮, 吕建瑞, 成鹏, 高静, 王梅, 李思远, 张宝平1()
1.咸阳市中心医院麻醉科
Effect of different sedation anesthesia depth to the perioperative inflammatory reaction in closed-loop target controlled infusion
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摘要:

【摘要】 目的 探讨全身麻醉中不同镇静麻醉深度对患者围术期炎性反应的影响。方法 择期腹部手术患者32 例,年龄选择48至72岁,体重指数22~27kg/m2,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将其分为2组(n=16),采用闭环靶控静脉输注技术维持麻醉深度两组分别为BIS45组BIS值45、BIS55组BIS值55。于手术开始前即刻(T1)、术中2 h(T2)、术后24 h(T3)、术后72 h(T4)时分别采集静脉血样,采用ELISA法测定血浆IL-6和IL-10浓度。结果 与BIS55组比较,BIS45组T1 时血浆IL-6、IL-10浓度差异无统计学意义(P>0.05),T2时血浆IL-6、IL-10浓度升高(P<0.05)。结论 麻醉深度BIS值55 同BIS值45相比对患者围术期炎性反应影响较轻。

关键词: 镇静麻醉深度;炎性反应;手术中并发症;手术后并发症
Abstract:

【Abstract】 Objective To investigate during the general anesthesia, the effect of different sedation depth of anesthesia the BIS settings for both 45 and 55 to the perioperative inflammatory reaction. Methods Thirty-two ASA Ⅰ-Ⅱ patients whose age were choosed 18 to 75yr,BMI 22~27kg/m2 undergoing gastrointestinal surgery were randomly divided into two groups: group BIS45、 group BIS55 (n = 16 each). Through closed-loop target controlled infusion technology to maintain different depth of sedation anesthesia in group BIS45 the BIS = 45, group B the BIS = 55. Venous blood samples were collected before surgery (T1), the start of the surgery two hours(T2),after the start of the surgery 24 and 72 hours postoperatively (T3, T4) for determination of plasma concentrations of interleukin-6, IL-10. Results Between the two groups, the T2 time point in group BIS45 than group BIS55, plasma cytokine interleukin-6(IL-6) and interleukin-10(IL-10) values was significantly increased (P = 0.048, P = 0.005). Plasma cytokine IL-6 within the two groups, group BIS45 at T2 than at T1 was significantly increased (P = 0.026) , plasma IL-10 within the two groups, group BIS45 at T2 than at T1 was significantly increased (P = 0.007). Conclusion The sedation anesthesia depth of BIS values 55 for surgery keep stable of inflammatory cytokines ,while the depth of BIS values 45 caused significantly increased of the preoperative cytokines. Therefore, the sedation anesthesia in BIS values 55 compared to BIS 45 inflammatory reaction is lighter.

Key words: Sedation anesthesia depth;inflammatory reaction; Intraoperative complications;Postoperative complications