听觉诱发电位指数与体外循环术中知晓的关系  

The relationship between auditory evoked potential index and incidence of awareness in cardiopulmonary bypass

作　　者：郭丽[1] 曲丽辉[2] 王义成[1] 陶海泉[3] 

机构地区：[1]哈尔滨医科大学第一临床医学院麻醉科,黑龙江哈尔滨150001 [2]哈尔滨医科大学生理学教研室 [3]哈尔滨医科大学第二临床医学院神经外科,黑龙江哈尔滨150081

出　　处：《哈尔滨医科大学学报》2008年第6期648-650,661,共4页Journal of Harbin Medical University

摘　　要：目的评价听觉诱发电位指数(AEPindex)在监测麻醉意识、减少术中知晓的临床价值。方法选择60例需体外循环(CPB)转机的患者。在体外循环转机开始时,随机分成3组,每组20例。Ⅰ组咪唑安定0.02 mg.kg-1;Ⅱ组咪唑安定0.2mg.kg-1;Ⅲ组咪唑安定0.4 mg.kg-1。术中监测各组病人不同时段的AEPindex,平均动脉压(MAP)和心率(HR)的各参数值,观察不同阶段各参数值的变化。结果诱导后AEPindex、平均动脉压、心率均明显降低。在气管插管、切皮、劈胸骨等时点,AEPindex均显著升高(P<0.05)。Ⅰ组发现1例术中知晓,Ⅱ组、Ⅲ组均无。结论体外循环转机时静注咪唑安定能减少术中知晓的发生率,咪唑安定0.2mg.kg-1不仅能防止术中知晓,还可获得更满意的麻醉水平。Objective To evaluate the clinical merit of auditory evoked potential index （AEPindex） in monitoring the consciousness of anesthesia and reducing the incidence of awareness in cardiopulmonary bypass （CPB） patients. Methods Sixty patients undergoing CPB were divided randomly into three groups, midazolam 0.02mg · kg^-1 ,midazolam 0.2mg · kg^-1 and midazolam 0.4mg · kg^-1group. Anesthesia was maintained with midazolam, fentany, pipecuronium and vasoactive agents. The AEPindex, mean arterial pressure （MAP） and heart rate （HR） were monitored and recorded in operation. Results AEPindex, MAP, HR decreased markedly after induction. The AEPindex in all patients significantly increased （ P 〈 0. 05 ） at induction, operation, sternum split. One patient has the incidence of awareness in midazolam 0.02mg · kg^-1 group, and none in midazolam 0.2mg · kg^-1 group and Midazolam 0. 4mg · kg^-1group. Conclusion During CPB, midazolam can avoid the incidence of awareness, midazolam 0.2mg · kg^-1precedes in control of MAP.

关 键 词：诱发电位 听觉 术中知晓 体外循环 

分 类 号：R614[医药卫生—麻醉学]