不同方法监测患者异丙酚镇静深度的准确性：BIS、 Narcotrend指数、意识指数与听觉诱发电位指数的比较  

Accuracy of different methods in monitoring depth of sedation induced by propofol： a comparison between BIS, NI, IoC and AAI

作　　者：张化[1] 邸立超 吕慧敏[1] 李莉[1] 

机构地区：[1]郑州大学第一附属医院麻醉科,450002 [2]河北医科大学第二医院麻醉科

出　　处：《中华麻醉学杂志》2015年第4期444-446,共3页Chinese Journal of Anesthesiology

摘　　要：目的 比较BIS、Narcotrend指数（NI）、意识指数（IoC）与听觉诱发电位指数（AAI）监测患者异丙酚镇静深度的准确性.方法 全麻下行择期手术患者60例,性别不限,年龄41 ～ 64岁,体重指数20～ 30 kg/m2,ASA分级Ⅰ或Ⅱ级.采用Marsh药代动力学参数TCI异丙酚,设定初始Ce为0.8 μg/ml,待Ce稳定后以0.1 μg/ml为梯度递增,并行OAA/S评分.TCI异丙酚前分别记录BIS值、NI值、IoC值和AAI值,此时OAA/S评分为5分,异丙酚TCI期间记录OAA/S评分依次达4分、3分、2分、1分时异丙酚Ce,采用随机数字表法确定BIS值、NI值、IoC值及AAI值的测定顺序,待数值稳定后记录5 s,取平均值.BIS值、NI值、IoC值及AAI值分别与异丙酚Ce进行Pearson相关分析.结果 BIS值、NI值、IoC值及AAI值与Ce的相关系数分别为rBIs-Ce=-0.829、rNI-Ce=-0.886、rIoC-Ce=-0.881、rAAI-Ce=-0.791 （P＜0.05）.rBIS-Ce、rNI-Ce、rIoC.Ce及rAAI-Ce之间比较差异无统计学意义（P＞0.05）.结论 中年患者非伤害性刺激条件下,BIS、NI、IoC及AAI监测异丙酚镇静深度的优势无差异.Objective To compare the accuracy of bispectral index （BIS）,Narcotrend index （NI）,index of consciousness （IoC） versus auditory evoked potential index （AAI） in monitoring the depth of sedation induced by propofol.Methods Sixty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 41-64 yr,with body mass index 20-30 kg/m2,scheduled for elective surgeries under general anesthesia,were enrolled in the study.Propofol was given by target-controlled infusion （TCI） with the initial target effect-site concentration （Ce） of 0.8 μg/ml using Marsh pharmacokinetic model,and then the Ce of propofol was increased by 0.1 μg/ml,and OAA/S was performed.Before TCI of propofol,the values of BIS,NI,IoC and AAI were recorded,and at the same time the value of OAA/S score was 5.During TCI of propofol,when OAA/S score reached 4,3,2 and 1 in turn,the Ce of propofol was recorded,the sequence for determination of the values of BIS,NI,IoC and AAI was determined using a random number table,and the values were then recorded for 5 s after the values were stable and then averaged.The parameters for vital signs were maintained within the normal range.Pearson correlation of BIS,NI,IoC and AAI values with Ce of propofol was analyzed.Results The correlation coefficients of BIS,NI,IoC and AAI values with the Ce of propofol were rBIs-Ce =-0.829,rSI-Ce =-0.886,rloC-Ce =-0.881 and rAAI-Ce =-0.791,respectively.There was no significant difference between rBIS-Ce,rNI-Ce,rIoC-Ce and rAAI-Ce.Conclusion There are no significant differences in the accuracy of BIS,NI,IoC or AAI in monitoring the depth of sedation induced by propofol in middle-aged patients with non-noxious stimuli.

关 键 词：监测 生理学 脑电描记术 诱发电位 听觉 清醒镇静 二异丙酚 NARCOTREND 意识指数 

分 类 号：R614[医药卫生—麻醉学]