脑电双频指数及听觉诱发电位指数监测普鲁泊福麻醉深度局限性的研究  

The limitations of the monitoring anesthetic depth by bispectral index and auditory evoked potential index during propofol anesthesia

作　　者：王永光[1] 李玉红[1] 徐建国[1] 

机构地区：[1]南京军区南京总医院麻醉科,江苏南京210002

出　　处：《医学研究生学报》2004年第7期607-609,共3页Journal of Medical Postgraduates

摘　　要：目的 :了解脑电双频指数 (BIS)和听觉诱发电位指数 (AEPI)监测全身麻醉深度的局限性。　方法 :收集普鲁泊福 (Propofol)麻醉中同时监测BIS和AEPI时 ,手术中出现AEPI值持续升高的 8例患者 ,记录麻醉诱导、手术期和恢复期各时间点BIS、AEPI、收缩期动脉压 (SAP)、舒张期动脉压 (DAP)、心率 (HR)、终末潮气二氧化碳分压 (PETCO2 )值和普鲁泊福血药浓度。并做AEPI、BIS、血药浓度之间相关性分析。术后第 1天随访有无术中知晓。结果 :麻醉诱导期和恢复期 ,AEPI和BIS与普鲁泊福血药浓度的变化呈线性负相关 ;而在手术期 ,AEPI值却偏离BIS值而明显增高 ,其中仅 2例有临床麻醉偏浅指征 ;3例术中AEPI值高达 90 % ,而且持续于手术全过程 ;手术期BIS值与普鲁泊福血药浓度呈线性负相关 (P <0 .0 1 ) ,而AEPI值则与二者均不相关 (P >0 .0 5 )。术后随访均无术中知晓。　结论 :BIS监测不能完全反映手术中麻醉偏浅 ;Objective: To analysis the limitations of the monitoring the depth of anesthesia by bispectral index(BIS) and auditory evoked potential index(AEPI) during Propofol anesthesia. Methods: Eight patients were studied under propofol anesthesia. BIS, AEPI, SAP,DAP,HR and propofol concentration were recorded during induction operation and recovery period. The correlation among BIS, AEPI and propofol concentration were analyzed. Patients were surveyed about awareness during operation the next day . Results: During induction and recovery period AEPI was correlated fairly well with BIS and Propofol concentration and r was 0.57, -0.48 and 0.59, -0.40 respectively. During operation period,AEPI increased sharply and was not correlated with BIS and propofol concentration( r was 0.17, -0.01 respectively) but only 2 patients had clinical signs of light anesthesia; meanwhile BIS and propofol concentration were well correlated( r =-0.61) .All the patients were not recall and awareness during operation. Conclusion: For some patients, neither AEPI nor BIS values can completely parallel with the depth of anesthesia during operation period.

关 键 词：脑电双频指数 听觉诱发电位指位 普鲁泊福 麻醉 

分 类 号：R338.8[医药卫生—人体生理学]