40-Hz听觉稳态反应电位指数用于监测麻醉深度的可行性  

Index of auditory steady state response as a monitoring of sedation levels during induction with target-controlled infusion of propofol

作　　者：孟萃珍[1] 张祥晶[1] 张炳熙[1] 郑汉光[2] 

机构地区：[1]首都医科大学附属北京同仁医院麻醉科,北京100730 [2]浙江省中西医结合医院麻醉科

出　　处：《浙江医学》2010年第8期1196-1198,共3页Zhejiang Medical Journal

摘　　要：目的评价40—Hz听觉稳态反应电位指数用于监测靶控输注异丙酚静脉全麻诱导过程对患者镇静深度的可行性。方法选ASAI级且听力正常的患者30例，采用靶控输注丙泊酚静脉诱导，按顺序维持7种目标浓度：0．5、1．0、115、20、25、3．0、3．5和4．0ug／ml。每一浓度均与效应室浓度平衡2分钟后顺次记录脑电双频指数（BIS）、40-HzASSR指数、收缩压、舒张压和OAA／S镇静评分。结果40—HzASSR指数、BIS与OAA／S镇静评分的相关系数分别为0．766（r2=0．587；P〈0．001）和0856（r2=0．761；P〈0．001）。40-HzASSR指数、BIS和OAA／S与目标血浆浓度的相关系数分别为0．873，0．851和0893（P〈0．001）。当患者意识消失时，OAA／S镇静评分由3分到2分，BIS降到60左右，40-HzASSR指数降到20左右，与意识消失前比较均有显著意义（P〈0．01）。结论40-HzASSR指数在靶控输注丙泊酚静脉全麻诱导过程中，可以反映患者镇静水平的变化。Objective To assess the auditory steady state response index （ASSR index） in monitoring the sedation levels during induction with target-controlled propofol infusion. Methods Thirty ASA grade I adult patients with normal hearing scheduled for elective surgery under general anesthesia were enrolled in this study. The depth of anesthesia was monitored by 40-Hz auditory steady state response, BIS and alertness/sedation scale （OAA/S）. Anesthesia was induced with target-controlled propofol infusion in different concentrations of 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5 μ g/ml and 4.0 μg/ml. BIS, 40-Hz ASSR index, SBP, DBP and OAA/S sedation score were recorded. Results The amplitude of the 40-Hz ASSR wave and the ASSR index were decreased with the increasing propofol concentration. The correlation coefficients of 40-Hz ASSR index and BIS to OAA/S sedation score were 0.766 and 0.856 respectively （P〈0.01）. 40-Hz ASSR index decreased to 22 （SD13） and the BIS decreased to 62 （SD11）, when the patients became unconscious （P〈0.01）. 40-Hz ASSR index was more likely to detect the transition from consciousness to unconsciousness.Conclusion 40-Hz ASSR index is useful in monitoring the sedation levels during induction procedure with target-controlled infusion of propofol.

关 键 词：二异丙酚 诱发电位 听觉 麻醉 

分 类 号：R764.4[医药卫生—耳鼻咽喉科]