听觉诱发电位和脑电双频指数预测全麻中内隐记忆的价值  

The efficacy of auditory evoked potentials and bispectral index in predicting implicit memory during general anesthesia

作　　者：俞莹芳[1] 周守静[1] 郭起浩[2] 

机构地区：[1]复旦大学附属华山医院麻醉科,上海市200040 [2]复旦大学附属华山医院神经内科,上海市200040

出　　处：《临床麻醉学杂志》2005年第9期583-585,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨在外科麻醉深度下,脑电双频指数(BIS)和中潜伏期听觉诱发电位(MLAEP)预测内隐记忆的价值.方法选择ASA Ⅰ～Ⅱ级择期全麻下行上腹部手术的病人39例,随机分为两组,观察组(T组)术中反复听8个双字词,时间为10 min,病人清醒后2 h作记忆测试;对照组(C组)术中听海浪声.T组根据测试结果再分为击中目标词病人(T1组)和未击中目标词病人(T2组),作BIS与MLAEP中Na、Pa潜伏期和Na至Pa的波幅(ANa-Pa)比较.结果两组病人均无外显记忆.C组19例中有3例击中目标词5个,T组20例中有8例击中目标词16个(P＜0.05).与T1组比较,T2组MLAEP中Na、Pa潜伏期显著延长,ANa-Pa显著变小(P＜0.05),而BIS无显著性差异.结论与内隐记忆未受到抑制的病人比较,内隐记忆形成被抑制的病人MLAEP明显被抑制,Na、Pa潜伏期显著延长,ANa-Pa显著减小,而BIS无明显变化.因此,MLAEP预测术中听觉刺激的内隐记忆的作用优于BIS.Objective To observe the effect of midlatency auditory evoked potentials（MLAEP） and bispectral index （BIS） in predicting implicit memory during surgical anaesthesia. Methods Thirty- nine patients of ASA grade Ⅰ - Ⅱ undergoing selective upper abdominal surgery under general anesthesia were randomly divided into two groups. Patients in control group （group C） were asked to listen to the sound of sea wave lasting for 10 min, while those in trying group （group T） to listen to 8 double sound words repeatedly, Explicit and implicit memory tests were assessed 2 h after emergency from anaethesia. According to the result of the tests, group T was subdivided into hit right patients （group T1 ） and hit wrong patients （group T2）, and IBIS, the latency of Na and Pa of MLAEP and the amplitude from Na to Pa were compared. Results None of the patients had explicit memory in both groups. In group T, there were 8 patients of hitting 18 target words, while 3 patients in group C hitting 5 target words（P〈0.05）. The latency of Na and Pa was significantly prolonged in group T1 compared with that in group T2. There was no significant difference in BIS between group T1 and T2. Conclusion MLAEP rather than BIS may help to predict implicit memory of auditory input during general anaesthesia.

关 键 词：内隐记忆 全身麻醉 脑电双频指数 中潜伏期听觉诱发电位 中潜伏期听觉诱发电位 脑电双频指数 内隐记忆 预测 价值 全麻 MLAEP 显著延长 上腹部手术 

分 类 号：R614.2[医药卫生—麻醉学]