成人与小儿耳鼻喉手术出现BIS值不对称及其临床意义的研究  

Study on the clinical significance of asymmetric BIS values appeared in adult and pediatric ENT surgery

作　　者：陈学均[1] 梁涛[1] 

机构地区：[1]四川省人民医院麻醉科,四川成都610072

出　　处：《西部医学》2013年第7期1036-1038,1041,共4页Medical Journal of West China

摘　　要：目的通过在耳鼻喉手术麻醉与苏醒期间,对成人与小儿患者前额双侧进行脑电监测,探索其双侧BIS值不对称的可能机制及相关的临床意义。方法分别选取63例(成人组)和61例(小儿组)患者,在耳鼻喉手术术中及术后持续监测其前额左右两侧BIS的变化情况。将患者仅出现单纯一侧BIS值超过或低于其基线的10%判定为"BIS值不对称";在出现BIS值不对称后给予吸痰刺激,若患者出现体动,则认为该BIS值不对称有临床意义。结果术中麻醉达稳态后,分别有93%和43%的成人与小儿患者发生了BIS值不对称现象。术后麻醉苏醒期,分别有57%和37%的成人与小儿患者发生了BIS值不对称现象。其中,成人患者中15%的BIS值不对称具有临床意义,小儿患者中13%的BIS值不对称具有临床意义。结论在耳鼻喉手术中,具有临床意义的BIS值不对称现象在成人与小儿患者人群的发生率均超过10%,且成人患者术中BIS值不对称的发生率明显高于小儿患者。Objective To investigate the incidence of clinically relevant asymmetry in bispectral index readings from different sides of the skull（using two monitors） during ear–nose–throat surgery in 63 adults and 61 children.Methods A unilateral increase or decrease 10% from baseline was defined as an ＇asymmetry＇.Asymmetry followed by movement after stimulation was defined as a ＇clinically relevant asymmetry＇.Results Asymmetry occurred in 59 out of 63 adults（93%） and in 26 out of 61 children（43%） during surgery and in 36 out of 63 adults（57%） and in 23 out of 61 children（37%） during recovery.Clinically relevant asymmetry was observed in 10 out of 63 adults（15%） and 8 out of 61 children（13%）.Conclusion Clinically relevant bispectral index asymmetry has been observed in 10% of paediatric and adult anaesthesia and may have clinical implications.The incidence of asymmetry was higher in adults during surgery.

关 键 词：耳鼻喉手术 BIS值不对称 成人与小儿 研究 

分 类 号：R762[医药卫生—耳鼻咽喉科]