心率变异性分析指标与脑电双频指数在麻醉深度监测中的相关性研究  

Correlation between monitoring parameters of reflecting vagal activity in heart rate variability analysis and bispectral index during general anesthesia

作　　者：王娟娟[1] 申岱[1] 贾晓宁[1] 李佩[1] 梁禹[2] 

机构地区：[1]天津医科大学口腔医院麻醉科,天津市300070 [2]天津市环湖医院麻醉科

出　　处：《临床麻醉学杂志》2011年第11期1048-1050,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨全身麻醉深度监测中反映迷走神经活动性的心率变异性(HRV)分析指标和脑电双频指数(BIS)的变化及相关性。方法择期行经鼻蝶入路垂体瘤切除手术的患者35例,ASAⅠ或Ⅱ级,测定麻醉诱导前(T0)、诱导插管(T1)、术中(T2)、停药后(T3)各5min的HR、MAP、BIS、相邻RR间期差的均方根(RMSSD)、高频(HF)和散点图短轴(SD1)变化。结果 T1时HR明显快于、MAP明显高于T0时(P<0.05或P<0.01);T2时HR明显慢于、MAP明显低于T0时(P<0.01);T3时HR明显快于、MAP明显高于T2时(P<0.01)。T1～T3时RMSSD、HF、SD1和BIS明显低于T0时,且T2时降低更为明显,而T3时明显高于T2时(P<0.01)。结论反映迷走神经活动性的HRV指标RMSSD、HF、SD1与BIS在监测麻醉深度时有一定的相关性。Objective To compare the changes of the parameters of heart rate variability （HRV） analysis and bispectral index（BIS） during general anesthesia, and to estimate the correlation between the parameters of heart rate variability analysis and BIS in monitoring the depth of anesthesia. Methods The parameters such as HR, MAP, BIS, RMSSD, HF,SD1 were monitored and recorded before induction （ T0 ）, intubation （T1）, during operation （T2）, after the cessation of intravenous （T3） in 35 patients, ASA Ⅰ or Ⅱ, undergoing elective surgery of pituitary adenomas resection via nasal cavity and sphenoidal sinus. Results Compared with T0, The value of HR was increased at T1 , and at T2 lower than at To, at T3 significantly higher than at T2. MAP shows the same changes with HR（P^0.05 or P〈0.01）. Compared with To ,the value of BIS at the other timepoints was decreased, but at T3 higher than at T2 （P〈0.01）. RMSSD, HF, SD1 show the same changes with BIS. Conclusion The indicators of HRV analysis-RMSSD, HF, SD1, reflecting the activity of the vagus nerve, showed correlation to BIS.

关 键 词：迷走神经 心率变异性 脑电双频指数 麻醉深度 

分 类 号：R614[医药卫生—麻醉学]