脑电图双频谱指数预测七氟醚麻醉病人切皮体动反应的临床评价  

The clinical evaluation of the bispectralindex of electroencephalogram in predicting movement during skin incision in patients under sevoflurane anesthesia

作　　者：张德林[1] 郭曲练[2] 陈先来[3] 张建国[4] 王艳青[2] 谭秀娟[2] 

机构地区：[1]福建医科大学附属协和医院麻醉科,福州市350001 [2]湖南医科大学附属湘雅医院麻醉科 [3]湖南医科大学医学信息系 [4]湖南医科大学统计学教研室

出　　处：《中华麻醉学杂志》1998年第5期279-282,共4页Chinese Journal of Anesthesiology

摘　　要：目的:用预测概率(P_K)评价七氟醚吸入麻醉时脑电图双频谱指数(BI)预测病人对切皮刺激体动反应的准确性。方法:选择行上腹部择期手术的成年患者29例,麻醉诱导用异丙酚及七氟醚,浓度随机为0.6MAC、1.0MAC、1.5MAC或2.0MAC的七氟醚维持15分钟以上切皮,观察病人的体动反应。取HR、MAP、SABP、BI及95%SEF等指标的切皮前1分钟数据,用于计算P_K。结果:MAC与BI预测概率显著高于0.5;95%SEF、SABP及MAP的预测概率稍低,但与0.5比较统计学上差别显著,其中95%SEF的P_K值与BI及MAC的P_K值比较差别显著;心率的P_K值接近0.5。结论:BI、SABP、MAP及95%SEF对七氟醚麻醉病人的切皮体动反应均有较好预测作用,但BI更敏感。Objective: To evaluate the efficacy of the bispectral index (BI) in predicting patient movement on skin incision under sevoflurane anesthesia with the PK statistic. Method: Twenty-nine adult patients. scheduled for elective upper abdominal surgery, were selected. Anesthesia was induced with propofol and 4%-5% sevoflurane in oxygen and maintained with one of four randomized sevoflurane concentrations (0.6MAC, 1.0MAC. 1.5MAC and 2.0MAC) for fifteen minutes, then skin incision was performed by the surgeon at the planned site of the surgery, and each patient was observed carefully about 2 minutes to detect purposeful movement. The data of BI, 95% SEF, MAP, SABP and HR in one minute before skin incision were applied to statistically analysis. Result: The P_K was significantly greater than 0.5 for the sevoflurane level and the BI. The PK of 95% SEF. SABP and MAP were less than that of the level of sevoflu or Bl. but was significantly greater than 0.5 The P_K of HR was close to 0.5. Conclusion: These indicators of B, BP and 95% SEF may predict patient movement to skin incision under sevoflurane anesthesia. of which the BI is the most sensi tive.

关 键 词：预测概率 七氟醚 脑电图 双频指数 麻醉深度 

分 类 号：R971.2[医药卫生—药品]