在使用苏芬坦尼尔诱导全身麻醉期间对瞳孔扩张反射的超声波测量:一项随机对照试验
Liji Xing1, Hong Xie1, Xuelan Zhou1
1Department of Anesthesiology, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
概括
超声波可以在麻醉期间监测瞳孔膨胀反射. 较高的sufentanil剂量可以抑制这种反射,这表明它在评估 nociception 的有效性.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 医学超声波 医学超声波
背景情况:
- 在全身麻醉期间监测痛感 (疼痛感知) 是一个挑战.
- 瞳孔膨胀反射是有害刺激的潜在指标.
- 超声波为观察瞳孔反应提供了一种新的方法.
研究的目的:
- 在全身麻醉期间使用超声波评估瞳孔扩张反射.
- 为了确定超声波瞳孔参数和sufentanil剂量之间的相关性.
- 在麻醉下评估瞳孔反射对有害刺激的敏感性.
主要方法:
- 93名接受全身麻醉的患者被分为三组,接受不同剂量的sufentanil (0,0.2或0.4μg/kg).
- 在苏芬坦尼尔注射5分钟后,进行了性刺激.
- 超声波用于测量瞳孔直径并分析四个时间点的瞳孔扩张反射参数 (幅度,速率,延迟,持续时间).
主要成果:
- 瞳孔扩张反射幅度和速率与sufentanil剂量负相关 (p<0.01).
- 瞳孔膨胀反射是唯一一个在30秒内对刺激做出反应的参数.
- 静止血压,静止血压和BIS并没有对刺激产生显著的反应.
结论:
- 超声波是观察全身麻醉期间瞳孔膨胀反射的可行的工具.
- 苏芬坦尼尔以剂量依赖的方式抑制瞳孔扩张反射.
- 超声波瞳孔扩张反射是麻醉期间有害刺激的敏感指标.
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