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双谱指数引导下右美托咪定和芬太尼辅助异丙酚达到气管插管足够深度的比较 — 一项双盲随机对照试验
贵州医科大学 麻醉与心脏电生理课题组
翻译：王波 编辑：王婷婷 审校：曹莹
背景和目的：喉镜检查和气管插管需要足够的麻醉深度。该研究的主要目的是比较芬太尼和右美托咪定在双谱指数（BIS）引导下气管插管达到足够麻醉深度所需的时间。
方法：在机构伦理委员会批准和书面知情同意后，这项随机研究对140名18至60岁的任意性别患者进行了研究，这些患者计划在全身麻醉下进行选择性手术。患者随机接受静脉注射右美托咪定1 μg/kg（D组）或芬太尼2 μg/kg（F组）。在麻醉诱导前10分钟内静脉输注药物。主要结局是达到BIS 50所需的时间。使用Student t检验比较正态分布变量，使用Mann-Whitney U检验比较非正态分布变量。使用卡方/ Fisher精确检验分析定性数据。P值<0.05被认为是有意义的。
结果：F组达到BIS 50的时间为1546(27)，少于D组1558 (11)s[95%可信区间（CI） 12[5.11, 18.89], P < 0.001]。两组之间的血流动力学参数在所有时间点均具有可比性，但心率明显较低。D组异丙酚消耗量显著低于F组[分别为125.9（25.36）和157.3 (42.80)mg，平均差异（95% CI） 31.4(- 44.16至- 20.63)P < 0.001)]。
结论：与芬太尼相比，右美托咪定达到BIS 50更快，并且具有异丙酚节约效果。
Bispectral index guided comparison of dexmedetomidine and fentanyl as an adjuvant with propofol to achieve an adequate depth for endotracheal intubation – A double blind randomised controlled trial
Background and Aims: Laryngoscopy and tracheal intubation require an adequate depth of anaesthesia. The study’s primary objective was to compare the time needed to achieve the bispectral index (BIS) guided adequate depth of anaesthesia for endotracheal intubation using fentanyl and dexmedetomidine.
Methods: After institutional ethics committee clearance and written informed consent, this randomised study was conducted on 140 patients of either gender between 18 and 60 years who were scheduled for elective surgeries under general anaesthesia. Patients were randomised to intravenous dexmedetomidine 1 μg/kg (Group D) or fentanyl 2 μg/kg (Group F). The drugs were given as an intravenous infusion over 10 min before induction of anaesthesia. The primary outcome was the time required to achieve BIS 50. Normally distributed variables were compared using Student’s t test, and nonnormally distributed variables were compared using the Mann–Whitney U test. Qualitative data were analysed using Chisquare/ Fisher’s exact test. A P value <0.05 was considered significant.
Results: The time to achieve BIS 50 was lesser in Group F, 1546 (27) as compared to Group D, 1558 (11) s [mean difference (95%confidence interval (CI) 12[5.11, 18.89]), P < 0.001]. Haemodynamic parameters were comparable at all time points between both the groups, except heart rate, which was significantly lower. Propofol consumption was significantly less in group D than in group F [125.9 (25.36) versus 157.3 (42.80) mg, respectively, mean difference (95% CI) 31.4 (-44.16 to -20.63) P < 0.001)].
Conclusion: Dexmedetomidine achieves BIS 50 faster and has a propofol sparing effect as compared to fentanyl.
