双额颞脑电双频指数监测在颈动脉手术中的应用  

Continuous bilateral bispectral index monitoring carotid artery surgery

作　　者：薛纪秀[1] 刘清海[1] 徐国勋[1] 赵国光[2] 范隆[1] 王克杰[1] 魏立民[1] 焦力群[2] 

机构地区：[1]首都医科大学宣武医院麻醉科,北京市100053 [2]首都医科大学宣武医院神经外科,北京市100053

出　　处：《临床麻醉学杂志》2008年第7期592-594,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察颈动脉阻断与开放时双额颞脑电双频指数(BIS)的变化。方法接受颈动脉内膜剥脱手术的患者10例,记录麻醉前(T1)、颈动脉阻断前5 min内(T2)、颈动脉阻断5 min内(T3)和开放后第一个5 min内(T4)四个时段的双侧BIS均值和平均动脉压及血流速度变化比值。结果T1时双侧BIS差异无统计学意义,4例T2时BIS手术侧较对侧低,5例T3时较对侧低,并且5例较T2降低。T4手术侧与T2比升高,对侧无明显变化。有1例阻断开放时双侧BIS降至40以下,其中手术侧达28.6;术后随访MRI显示交界区出现多发小梗死灶。结论全身麻醉下颈动脉阻断时,当血供代偿不足或出现范围较广的脑梗死时,BIS值明显降低,可以对脑缺血提供参考依据。Objective To study the changes of the bilateral BIS variables during clamping and declamping carotid artery （CA） under general anesthesia. Methods Ten patients undergoing carotid endarterectomy（CEA） were studied. The bilateral BIS was monitored continuously before anesthesia （T1）, before clamping（T2 ） CA, at 5 min after clamping CA （T3） and declamping of CA （T4）. Mean artery pressure（MAP） and flow velocity ratio （FV）were recorded at the same time. Results The bilateral BIS values were not different at T1. The BIS value was lower on the side of operation than that on the opposite side at T2, so did at T3 in 5 cases. The mean of BIS variable at T4 as higher than that at T2. BIS was below 40 at T3 and T4 in one case. Conclusion During clamping CA,a decrease of cerebrovascular blood flow can be shown by a reduction of BIS value in the patients undergoing CEA.

关 键 词：脑电双频指数 颈动脉阻断 监测 

分 类 号：R614[医药卫生—麻醉学] R653[医药卫生—外科学]