舒芬太尼复合异丙酚麻醉下体外循环冠脉搭桥术患者双频谱指数与熵指数的关系  

Relationship between BIS and state and response entropy values in patients undergoing coronary artery bypass grafting under sufentanil and propofol anesthesia

作　　者：严敏[1] 戴安卢[1] Berthold Bein PerterJ Tonner Jens Schloz 

机构地区：[1]浙江大学医学院附属第二医院麻醉科,杭州市310009 [2]Department of Anesthesiology and Intensive Care Medicine,University Hospital Schleswig-Holstein,Campus Kiel,Germany [3]Department of Anesthesiology and Intensive Care Medicine,University Hospital Schleswig-Holstein,CampusKiel,Germany

出　　处：《中华麻醉学杂志》2006年第10期929-931,共3页Chinese Journal of Anesthesiology

摘　　要：目的评价非肌松、深麻醉状态下,双频谱指数(BIS)反映麻醉深度的准确性。方法选择ASAⅢ级的冠脉搭桥术患者59例,麻醉诱导:静脉注射异丙酚2 mg／kg、舒芬太尼1μg／kg、罗库溴铵0．6 mg／kg,术中麻醉维持采用静脉持续输注异丙酚3-4 mg·kg-1·h-1、舒芬太尼1μg·kg-1·h-1。于麻醉诱导前、麻醉诱导开始后1、2、3、4 min、气管插管后即刻、气管插管后1 min、切皮后即刻和劈胸骨后即刻记录BIS、状态熵(SE)和反映熵(RE)。结果与麻醉诱导前相比,麻醉诱导开始后1、2、3、4 min和气管插管后即刻、气管插管后1 min、切皮后即刻及劈胸骨后即刻BIS、SE和RE均下降(P<0．05)。与SE相比,RE在各观察点均升高(P<0．01)。麻醉诱导期间BIS与SE和RE各时间点观察值之间呈明显正相关,r分别为0．898、0．908(P<0．01)。结论在非肌松、深麻醉状态下,BIS对舒芬太尼复合异丙酚静脉麻醉深度的监测不受肌电活动的影响。Objective To evaluate the accuracy of BIS as a monitor of the depth of anesthesia in patients undergoing coronary artery bypass grafting （CABG） under propofol and sufentanil anesthesia regardless of myoelectrical activity. Methods Fifty-nine ASA Ⅲ patients of both sexes scheduled for elective CABG were enrolled in this study. The patients were premedicated with oral midazolam 7.5 mg. Anesthesia was induced with propofol 2 mg·kg^-1, sufentanil 1 μg·kg^-1 and rocuronium 0.6 mg·kg^-1 and maintained with propofol infusion at 3- 4 mg·kg^-1·h^-1 and sufentanil 1 μg·kg^-1·h^-1 after tracheal intubation. BIS （type A2000, Aspect Comany, USA） and state and response entropy （SE, RE） were monitored and recorded and compared before anesthesia （baseline）, at 1, 2, 3 and 4 rain after induction of anesthesia, immediately and 1 rain after tracheal intubation, immediatoly after skin incision and stemotomy. Results BIS, SE and RE values were significantly decreased after induction of anesthesia, tracheal intubation, skin incision and sternotomy as compared to the baseline values. The RE was significantly higher than SE at all time points. There was a significant correlation between BIS and SE （ r =0.898, P〈0.01） and between BIS and RE （r =0.908, P〈0.01）.Conclusion During deep hypnosis BIS can provide information about the level of consciousness during propofol and sufentanil anesthesia regardless of myoelectrical activity.

关 键 词：脑电描记术 舒芬太尼 二异丙酚 麻醉 静脉 

分 类 号：R614[医药卫生—麻醉学]