脑电双频指数和听觉诱发电位指数监测在术中血流动力学状态比较  

作　　者：赵晓亮[1] 朱钧[2] 徐志新[3] 

机构地区：[1]新疆医科大学,乌鲁木齐830054 [2]新疆自治区人民医院麻醉科,乌鲁木齐830001 [3]新疆医科大学第一附属医院麻醉科,乌鲁木齐830054

出　　处：《中国医疗前沿》2009年第21期8-9,30,共3页China Healthcare Innovation

摘　　要：目的比较BIS和AAI监测麻醉深度指导雷米芬太尼靶控输注在腹腔镜胆囊切除术中病人对刺激的心血管反应。方法56例择期行腹腔镜胆囊切除术病人,随机分为AAI组(术中监测AAI)和BIS组(术中监测BIS),麻醉诱导方法相同,诱导后根据病人BIS值50±5或AAI值20±5调整雷米芬太尼持续输注靶控浓度,每次以1ng/ml为增减变量。记录诱导前T0、全麻诱导后气管插管前T1、气管插管T2、人工气腹开始T3、人工气腹开始后10minT4、手术结束停止给药后5min后T5等各时点AAI或BIS值,记录各时点平均动脉压和心率。术后计算两组雷米芬太尼总用量。结果两组诱导后AAI和BIS均迅速下降,在插管时,AAI组AAI值明显升高,BIS组BIS值无明显变化,两组平均动脉压在T1降低,T2、T3时点升高,且与T0比明显升高(p<0.05,p<0.01),组间比较T3时点BIS组高于AAI组,且BIS组发生高血压比例明显大于AAI组。结论AAI和BIS都不能很好预测伤害刺激的心血管反应,但AAI比BIS相对较敏感。Objective To compare the different hemodynamic response of surgical stimulations when patients under BIS or AAI monitoring. Methods 56 patients were randomly divided into 2 groups. AAI were monitored in AAI group,and BIS were monitored in BIS group. After induced by Target-Controlled Infusion for remifentanil 4ng/ml,effect-site concentration of remifentanil was adjusted according to BIS or AAI which were kept in extent of 50±5 or 20±5. MAP and HR were recorded. Results AAI and BIS were decreased after induction. The AAI increased at the time of intubation but not BIS. In both groups MAP were increased at the time of intubation and surgical stimulated. But the degrees were lower in AAI group. And there were less hypertension cases in AAI group. The total dose of remifentanil was lower in AAI group than in BIS group. Conclusion AAI and BIS cann＇ t anticipated the hemodynamic response of surgical stimulations, but AAI is a more sensitive indicator.

关 键 词：脑电双频指数 听觉诱发电位指数 血流动力学 

分 类 号：R338.8[医药卫生—人体生理学] R614.3[医药卫生—基础医学]