听觉诱发电位和脑电双频指数用于预先镇痛后全子宫切除术后全麻恢复期意识恢复程度的比较  

Comparison between the performance of bispectral and auditory evoked potential to predict the level of consciousness after preemptive analgesia during recovering period.

作　　者：张毅[1] 刘凌云[1] 张咸伟[1] 田玉科[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉学教研室,430030

出　　处：《中国妇幼保健》2006年第1期27-29,共3页Maternal and Child Health Care of China

摘　　要：目的：脑电双频指数（BIS）和听觉诱发电位（AEP）监测预先镇痛后全子宫切除术后全麻恢复期意识程度能比较。方法：选择40例ASAⅠ～Ⅲ级行全子宫切除术的病人，随机分为对照组（n=20）和预先镇痛组（n=20），所有病人均在静-吸复合麻醉下完成手术。预先镇痛组在手术开始前使用曲马多1．5mg／kg。术后推入苏醒室，记录BIS、AEP、VAS镇痛评分和术后寒颤和躁动的发生率。结果：①VAS，预先镇痛组优于对照组（P〈0．05）；②OAA／S评分、BIS和AEP，OAA／S评分和BIS在5min和10min两个时间点，预先镇痛组低于对照组（P〈0．05），而AEP在各个时间点，预先镇痛组均低于对照细（P〈0．05）；③术后寒颤和躁动的发生率，预先镇痛组明显低于对照组。结论：AEP和BIS均能够良好地反映患者的意识恢复程度，但BIS主要反映患者镇静程度，而AEP更能够综合反映患者镇静、镇痛程度。Objective： To observe whether preemptive analgesia affect recovering degree of awareness in postoperative patients. Methods： Forty patients for complete hysterectomy were randomly divided into control group （n = 20） and preemptive analgesia group （n = 20） . All patients received the operations under general anesthesia. Before operation, patients in the preemptive analgesia group were given tramadol 1.5 mg/kg intravenously. After operation, all patients were transported into recovering room. OAA/S sedation score, VAS, BIS and ratio of postoperative shaking chill and harass were recorded. Results： ①VAS of preemptive analgesia group was much better than that of control group. （P〈0.05 ） ; ②OAA/S and Bis were significantly lwer in pre- analgesia group than that of control group 5 and 10 min after extubation. But AEP was significantly lower in pre - analgesia at all times after extubation ; ③The ratios of postoperative shaking chill and harass were also significantly lower in preemptive analgesia group than that in control group. （ P 〈 0.05 ） . Conclusion ： Both AEP and BIS can predict fairly well the level of consciences, during recovering periods after general anesthesia. But AEP is more comprehensive than BIS.

关 键 词：听觉诱发电位 脑电双频指数 预先镇痛 意识恢复程度 

分 类 号：R713[医药卫生—妇产科学]