脑电双频指数对镇静深度和血液动力学预测作用的研究  

A study of bispectral index predicting the depth of sedation and hemodynamic response during propofol and midazolam anesthesia

作　　者：张德林[1] 庄小凤[1] 裘卫东 蒋豪[1] 薛张纲[1] 

机构地区：[1]复旦大学附属中山医院麻醉科,上海市200032 [2]浙江省临海市第一人民医院麻醉科

出　　处：《临床麻醉学杂志》2004年第6期330-332,共3页Journal of Clinical Anesthesiology

摘　　要：目的　研究脑电双频指数 (BIS)对镇静深度和血液动力学的预测作用。方法　 30例ASAⅠ～Ⅱ级、择期行胸腹部手术患者 ,随机分为丙泊酚组 (P组 )和咪唑安定组 (M组 ) ,每组 15例。以恒定的给药速度 (P组为 8mg·kg 1·h 1,M组为 0 5mg·kg 1·h 1)持续静脉输注 ,每 3分钟行OAA/S评分一次 ,直到OAA/S评分达 1分停止给药。记录评分前即刻的BIS、收缩压 (SBP)、舒张压(DBP)、激发指数 (ACI)。结果　随着镇静加深 ,两组BIS、SBP、DBP、ACI均明显下降 ,而心率 (HR)变化不明显 ;BIS预测OAA/S与SBP、DBP和ACI的预测概率 (Pk)值均有显著性差异 (P <0 0 1) ,而BIS预测HR的Pk值无显著性差异。BIS预测P组的OAA/S、SBP、DBP的Pk值较M组的相同指标的Pk值明显高 ,而BIS预测ACI的Pk值无显著性差异。结论　BIS对麻醉的意识成分变化预测效果较好 ,对血压和心肌收缩性变化也有一定的预测能力 ,但明显较镇静深度预测能力差 ,BIS与心率变化无关。Objective To investigate the predictive effect of bispectral index(BIS)on the depth of sedation and hemodynamic responses during propofol and midazolam anesthesia.Methods Thirty ASA Ⅰ-Ⅱ pathients undergoing elective thoracic or abdominal surgery were randomly assigned to receiving a constant rate infusion of propofol 8 mg·kg -1 ·h -1 (group P),or midazolam 0.5 mg·kg -1 ·h -1 (group M).Sedation was titrated to Observerss Assesment of Alertness-Sedation score(OAA/S) of 1.0,which was measured every 3 min.The value of BIS,systolic pressure(SBP),diatolic pressure(DBP),and ACI was recorded just before sedation level assessment.Results In two groups,with increasing sedation,BIS,SBP,DBP and ACI decreased significantly,but the changes in HR were less significant.The Pk values for BIS predicting the changes of OAA/S,SBP,DBP in group P were significantly better than those in group M(P<0.01),which was not significantly different in predicting the changes in ACI between the two groups.Conclusions BIS is a reliable guide to the depth of sedation,but not to the adequacy of anesthesia level for preventing hemodynamic responses during propofol or midazolam anesthesia.

关 键 词：脑电双频指数 镇静深度 血液动力学 预测作用 丙泊酚 咪唑安定 麻醉 

分 类 号：R614[医药卫生—麻醉学]