脑电双频谱指数和听觉诱发电位指数监测静吸复合全麻时的麻醉深度  

Effects of BIS and AEPindex monitoring on the depth of anesthesia in intravenous-inhalational anesthesia

作　　者：杨浩波[1] 郭曲练[1] 

机构地区：[1]中南大学湘雅医院麻醉科,长沙410008

出　　处：《中南大学学报（医学版）》2007年第1期127-131,共5页Journal of Central South University ：Medical Science

摘　　要：目的:观察异氟醚和异丙酚静吸复合全麻时脑电双频谱指数(bispectral index,BIS)和听觉诱发电位指数(auditory evoked potentials index,AEPindex)的变化,探讨在静吸复合全麻中应用BIS和AEPindex监测麻醉深度的意义。方法:ASAⅠ～Ⅱ级择期行腹部外科手术的患者40例,随机分为I1组(n=20)和I2组(n=20),I1组异氟醚呼末浓度为0.6MAC,I2组为1.0MAC。异丙酚和维库溴铵诱导气管内插管后,吸入异氟醚,呼末浓度分别为0.6/1.0MAC,稳定20min后靶控输注异丙酚,靶浓度从1.0μg/mL开始,以0.5μg/mL递增,靶浓度稳定在3.0μg/mL开始手术。记录MAP,HR,BIS和AEPindex。结果:MAP和HR的变化与异氟醚呼末浓度和异丙酚浓度无相关性。BIS和AEPindex与异氟醚呼气末浓度的相关系数分别为-0.757,-0.819和-0.832,-0.878;与异丙酚靶控浓度的相关系数分别为-0.932,-0.888和-0.920,-0.923(P<0.001)。BIS和AEPindex与插管刺激的相关性为-0.544和-0.728,BIS和AEPindex与切皮和探查的刺激无线性相关。结论:BIS和AEPindex能可靠地监测异氟醚-异丙酚复合麻醉的深度。在反应气管插管的刺激上AEPindex明显优于BIS,但两者均不能有效地监测切皮和探查时的心血管反应。Objective To evaluate the effects of bispectral index （BIS） and auditory evoked potentials index （AEPindex） monitoring on the depth of anesthesia in inhalation of isoflurane and target-controlled infusion （TCI） of propofol, and to observe the changes of BIS and AEPindex. Methods Fourty ASA physical status Ⅰ -Ⅱ patients undergoing selective abdominal operations were divided into 2 groups randomly ： Group Ⅰ1 （ the end-tidal isoflurane concentration was 0.6 MAC, n = 20 ） and Group Ⅰ2 （ the end-tidal isoflurane concentration was 1.0 MAC, n = 20 ）. Anesthesia was induced with proprofol and vecuroninm. After the tracheal intubation, the patients were ventilated with 0.6/1.0 MAC isoflurane in pure oxygen, and after 20 minutes, propofol was administered with TCI according to the different target plasma concentrations from 1.0 g/mL to 3.0 g/mL（ increasing 0.5 g/mL each time ）. The changes of MAP, HR, BIS and AEPindex were recorded simultaneously. Results There was no close correlation between MAP, HR and the end-tidal isoflurane concentration, target plasma concentration of propofol. The correlation coefficiencies between BIS, AEPindex and the end-tidal isoflurane concentration were -0. 757, -0. 819 and -0. 832, -0. 878 （P 〈 0.001 ）, respectively ; those between BIS, AEPindex and the target plasma concentration of propofol were -0.932, - 0. 888 and - 0. 920, - 0. 923 （ P 〈 0. 001 ）. The correlation coefficiencies between BIS, AEPindex and the stimulation of endotracheal intubation were - 0. 728 and 0. 544, respectively; however, there was no close correlation between BIS , AEPindex and the stimulation of skin incision, and exploration. Conclusion BIS and AEPindex are reliable parameters to monitor the depth of anesthesia of isoflurane and propofol combined anesthesia; and in response to the stimulation of tracheal intubation, AEPindex is better than BIS, but BIS and AEPindex can not be used to predict the cardiovascular reaction of skin incision and exploration.

关 键 词：脑电双频谱指数 听觉诱发电位指数 麻醉深度 异氟醚 二异丙酚 

分 类 号：R614.2[医药卫生—麻醉学]