麻醉深度指数用于全麻手术期间麻醉深度监测的临床评价  

Significance of cerebral state index used in patients undergoing general anesthesia

作　　者：冯微[1] 赵国庆[1] 叶虹[1] 郑艳[1] 张禾田[1] 

机构地区：[1]吉林大学中日联谊医院麻醉科,长春市130031

出　　处：《临床麻醉学杂志》2009年第6期493-496,共4页Journal of Clinical Anesthesiology

摘　　要：目的评价麻醉深度指数(CSI)监测麻醉深度的准确性及实用性。方法ASAⅠ或Ⅱ级患者40例随机均分为两组。采用咪唑安定、芬太尼、丙泊酚、维库溴铵诱导和维持。A组以CSI监测数据判断麻醉深度并调整用药,使CSI维持在50±5。B组根据经验用药。常规监测SBP、DBP、HR、ECG、SpO2、CSI,计算用药总量,记录苏醒时间;诱导期进行警觉/镇静(OAA/S)评分,计算CSI对于OAA/S的等级相关系数。结果麻醉期间,B组的SBP、DBP、HR、CSI波动明显大于A组(P<0.05);A组的苏醒时间明显短于B组,拔管后躁动、嗜睡、恶心、呕吐的病例数少于B组;A组无一例术中知晓,B组有1例发生术中知晓。CSI与OAA/S评分具有显著的等级相关性。结论CSI可动态反映大脑生理功能的变化,有助于判断全麻深度,指导麻醉用药。Objective To evaluate the significance of cerebral state index（CSI） used in patients undergoing general anesthesia. Methods Forty patients, ASA class Ⅰ or Ⅱ, were randomly allocated into two groups with 20 cases each. Anesthetic depth was judged and anesthetics was administred by CSI monitoring （being kept in 50± 5） in group A or based on the experience of anesthetist. Anesthesia was induced and maintained with midazolam, fentanyl, propofol and vecuronium. SBP, DBP. HR, ECG, SpO2 and CSI were monitored. Awake time and anesthetic consumption were recorded. The OAA/S was graded during induction and correlative coefficient between OAA/S and CSI was calculated. Results The changes of SBP, DBP, HR and CSI were less in group A than those in group B （P〈0. 05）. Awake time was shorter in group A than that in group B and restlessness drowsiness, nausea and vomitting after extubation were less in group A than those in group B. No awareness case during operation was seen in group A, but one case suffered from awareness in group B. The rank correlation between CSI and OAA/S was significant. Conclusion CSI monitoring can dynamicly reflect cerebral physilological functions during general anesthesia and is helpful in judging anesthesia depth and directing the administration of anesthetics.

关 键 词：麻醉深度指数 全身麻醉 监测 

分 类 号：R614[医药卫生—麻醉学] R472.3[医药卫生—外科学]