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老年人脑电双频指数、咪达唑仑血药浓度与镇静深度的相关性研究
其他题名Study for the correlation among bispectral index and blood midazolam concentration with level of sedation in the elderly
赵艳; 蒋建渝; 许川雅; 耿秋明; 吴新民
关键词老年人 咪达唑仑 清醒镇静 脑电双频谱指数
刊名中华麻醉学杂志
2001
DOI10.3760/j.issn:0254-1416.2001.05.003
21期:5页:269-272
收录类别中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型Journal Article
摘要目的探讨老年手术病人椎管内麻醉后用咪达唑仑镇静,脑电双频谱指数、咪达唑仑血药浓度和镇静深度间的相关关系.方法 44例ASA I~Ⅱ级择期手术病人,不用术前药.分为老年组(61~82岁)和年轻组(19~43岁),每组22例.为尽快达到稳态血药浓度,采用靶控输注.咪达唑仑靶浓度从50ng/ml起渐增,直至病人对轻推无反应(意识消失),每个浓度维持15min.连续记录EEG参数.在每一稳态血药浓度末,记录BIS、95%SEF,桡动脉取血(高效液相色谱法测定咪达唑仑血药浓度),并评定镇静深度(OAA/S评分法).用Spearman's等级相关进行相关分析,并计算预测概率(Pk)值.结果两组BIS(r=0.935~0.955)与镇静水平的相关性优于血药浓度(r=-0.849~-0.870)和95%SEF(r=0.503~0.571).BIS的Pk值高(0.942~0.972).在同一镇静评分(OAA/S 4~1)时,老年组BIS值明显高于年轻组(P<0.01),而血药浓度低于年轻组.结论 BIS在监测咪达唑仑镇静水平及预测意识消失方面有重要价值.在同一镇静评分时,老年人BIS值高于年轻人. Objective To determine the relationship of bispectral index (BIS) and blood midazolam concentration with levels of sedation in elderly patients during operation under intrathecal anesthesia.Methods Forty-four ASA Ⅰ- Ⅱ patients scheduled for elective surgery on lower abdomen or lower extremities under epidural or combined spinal-epidural anesthesia were studied. There were two groups of 22 patients each: the elderly group (61-82 yr), and the young group (19-43 yr). The target-controlled infusion (TCI) was used to achieve a rapid induction and maintenance of a target blood concentration of midazolam. Blood concentration of midazolam was started from 50 ng/ml and then gradually increased until loss of consciousness. Each concentration was maintained for 15 min. BIS and 95 % SEF were continously monitored and recorded at the end of each blood concentration. At each concentration arterial blood samples were obtained for determination of midazolam concentration by high performance liquid chromatography,and the level of consciousness or sedation was evaluated using the observer' s assessment of alertness/sedation scale (OAA/S). The BIS and the measuredmidazolam concentration were correlated with the OAA/S score using nonparametric Spearman' s rank-correlation analysis. The prediction probability (Pk) was also calculated. Results The BIS correlated with OAA/S score better in both groups ( r = 0. 935-0.955) than the measured midazolam concentration ( r = -0.849 - -0. 870) and 95 % SEF ( r = 0. 503 - 0. 571 ). The Pk for BIS ranged from 0.942 - 0.972, indicating a very high performance for correctly predicting probability of unconsciousness . The elderly group exhibited higher BIS values and lower plasma nidazolam concentration than the young group at the same OAA/S score (4-1). Conclusions BIS appears to be a valuable monitoring of the level of sedation and loss of consciousness in both the elderly and young , but the elderly has higher BIS values than the young at the same sedation score.Key Words Aged Plasma concentrastion Midazolam Conscious sedation Bispectral index
语种中文
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文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/72329
专题北京大学第三临床医学院_麻醉科
作者单位1.北京大学第三医院麻醉科
2.北京大学第三医院中心实验室
3.本大学第一医院麻醉科
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赵艳,蒋建渝,许川雅,等. 老年人脑电双频指数、咪达唑仑血药浓度与镇静深度的相关性研究[J]. 中华麻醉学杂志,2001,21(5):269-272.
APA 赵艳,蒋建渝,许川雅,耿秋明,&吴新民.(2001).老年人脑电双频指数、咪达唑仑血药浓度与镇静深度的相关性研究.中华麻醉学杂志,21(5),269-272.
MLA 赵艳,et al."老年人脑电双频指数、咪达唑仑血药浓度与镇静深度的相关性研究".中华麻醉学杂志 21.5(2001):269-272.
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