Clinical Study For Analeptic Effect Of Flumazenil After Intravenous Anesthesia Under Bispectral Index Monitoring

Obejective: In this study, under the monitoring of bispectral index （BIS）, afterthe operation under the total intravenous anesthesia, delivers the flumazenil and viewits clinical analeptic effect. At the mean time, reveal the theoretical basis of theanaleptic effect of flumazenil.Methods:120patients who have been conducted thoracic surgery under totalintravenous anesthesia at selective time,40⁶0years old, ASA grade â… -â…¡, weredivided into four groups randomly, and30patients in each group. In groups N₁and M,the induction and maintaining of anesthesia are all using the Midazolam （M）+Sufentanil （SF）+Atracurium （A）; while, in groups N₂and P, the Propofol （P）+Sufentanil （SF）+Atracurium （A） were used for the induction and maintaining of theanesthesia. After the operation of the four groups, when the patients are under theregaining of physiologic respiration, the pupil restoring to the preoperative status andBIS is60, for groups N₁and N₂, the normal saline was delivered intravenously; andfor groups M and P, the flumazenil was injected intravenously at0.007mg/kg. The BIS,MAP, HR, OAA/S scores at premedication （T₀）,1（T₁）,3（T₂）,5（T₃）,10（T₄）,30（T₅）min after the medication; the analeptic time, and the time of extract of the trachealcatheter were recorded; and record the side effect rate after operation.Results: In group M,1min after medication, comparing with premedication andgroup N₁, the BIS, MAP, HR, OAA/S scores are significantly higher （P<0.05）; and theanaleptic time and time of extract of the tracheal catheter is significantly shorter ingroup M than in group N₁（P<0.05）.3min after medication, the BIS, MAP, HR,OAA/S scores in group P increased significantly comparing to premedication andgroup N₂（P<0.05）; the analeptic time and time of extract of the tracheal catheter issignificantly longer in group N₁than in group N₂（P<0.05）; while, the analeptic timeand time of extract of the tracheal catheter in group M is significantly shorter than in group P（P<0.05）. After operation, the side effect rate in group M is significantly higherthan in group N₁（P<0.05）; however, comparing group P with group N₂, the side effectrates have no statistical meaning （P>0.05）.Conclusion:1. Under total intravenous anesthesia, when Midazolam or Propofol were used as theanaesthetic, flumazenil could improve the BIS score effectively.2. Under total intravenous anesthesia, flumazenil could effectively antagonize thesedative effect of Midazolam or Propofol, facilitate the consciousness recovery ofthe patients after operation.3. Flumazenil is safe, effective and effect clear in the analeptic process after operation.4. Flumazenil could facilitate the wake up of the patients who were under totalintravenous anesthesia, providing a clinical method for accelerate theconsciousness recovery of the patients.