听觉诱发电位指数在全麻诱导插管期间麻醉监测的应用  

Evaluate the Effective of Auditory Evoked Potential Index During Induction and Tracheal Intubation on Anaesthesia Depth Monitoring

作　　者：孙宏伟[1] 李萍[2] 龚秀萍[1] 李志学[1] 

机构地区：[1]哈尔滨医科大学第一临床医学院麻醉科,哈尔滨150001 [2]首都医科大学附属北京同仁医院麻醉科,北京100730

出　　处：《中国医药导刊》2004年第3期182-183,185,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:观察听觉诱发电位指数全麻诱导期间的变化,评价其在临床上监测麻醉深度的价值。方法:选择胸腹部手术且听力正常的病人36例(ASAⅠ～Ⅱ),分别采用Mid-Fen-Ro(Ⅰ组)和Mid-Fen-Pro-Ro(Ⅱ组)顺序诱导。监测记录诱导前基础值(T_0),静注Mid后1min(T_1)、静注Fen后1min(T_2)、Ⅱ组静注Pro后1min(T_3)、静注Ro后1minⅠ组(T_3)和Ⅱ组(T_4)、插管后1minⅠ组(T_4)和Ⅱ组(T_5);上述各点的AEPI、MAP和HR。结果:两组病人全麻诱导气管插管前均能达到满意的麻醉深度,但Ⅰ组气管插管后MAP和HR均较T_0和插管前明显升高(P<0.01),插管前后比较AAI明显升高,较T_3值有显著差异(P<0.001)Ⅱ组气管插管后(T_5)MAP和HR与T_0比较无差异,较T_4也升高,但不如Ⅰ组明显;AAI也较T_4明显升高,但仍处于临床麻醉状态。结论:麻醉诱导期间AAI能准确地反映临床镇静麻醉深度;咪达唑仑和异丙酚联合使用能平稳地诱导麻醉且用药量小。Objective: To observe the changes of auditory evoked potentials index(AEPI) during induction and tracheal intubation and evaluate its value on anasthesia depth monitoring. Methods: Thirty--six ASAⅠ--Ⅱ patients scheduled for elec- tive surgery under general anesthesia. Patients wh psychoneural diseases or hearing disturbances were excluded. Anesthesia were induced respectively with midzolam 0.2mg/kg, fentanyl 3μg/kg, rocuronium 0.6mg/kg and midzolam 0.02mg/kg, fentanyl 3μg/kg,propofol 0.8mg/kg, meuronium 0.6mg/kg given Ⅳ in sequence with an interal of 1 mintue between two injections and maintained with enfluren inhalation. The depth of anesthesia was monitored by AAI. These parameters were monitored continu- ously and recorded before induction (T_0), at 1 minute after each injection and 1 minute after intubation. Results: All patients recieved satisfactory depth of anesthesia before intubation. But compared with basic value (T_0), the value of MAP and HR after intubation (T_4) increased significantly in group Ⅰ, AAI increased significantly compared with that of T_3 (P<0.001). In group Ⅱ, MAP and HR after intubation (T_5) have no significant difference with basic value (T_0) (P> 0.05), MAP, HR and AAI have signif- icant difference with that of T_4 (P<0.05), but patients were in clinical anesthetized state. Conclusions: AAI can predict fairly well the level of sedation during induction and tracheal intubation. Induction of anesthesia with intravenous midazolam--fen- tanyl--propofol is smooth and effective with little circulatory disturbance.

关 键 词：听觉诱发电位 全麻 监测 气管插管 咪达唑仑 二异丙酚 

分 类 号：R614[医药卫生—麻醉学]