脑电双频指数用于监测颅脑手术病人镇静深度的可行性:与非颅脑手术的比较  

The feasibility of bispectral index for monitoring the depth of anesthesia in patients undergoing craniotomy: comparison of non-intracranial tumor surgery

作　　者：张海静[1] 菅敏钰[1] 张利勇[1] 景龙年[1] 彭宇明[1] 韩如泉[1] 

机构地区：[1]首都医科大学附属北京天坛医院麻醉科,北京100050

出　　处：《首都医科大学学报》2017年第3期457-460,共4页Journal of Capital Medical University

基　　金：北京市医院管理局"扬帆计划"重点医学方向(ZYLX201708);首都卫生发展科研专项重点攻关项目(2016-1-20410)~~

摘　　要：目的比较脑电双频指数(bispectral index,BIS)用于颅脑和非颅脑手术病人监测麻醉深度的差异,探讨BIS监测颅脑手术病人镇静深度的可行性。方法择期全身麻醉下行幕上入路颅内肿瘤切除术病人25例,美国麻醉医师协会(American Society of Anesthesiologists,ASA)Ⅰ-Ⅲ级,椎管内肿瘤切除术病人25例作为对照。入室后按标准电极贴敷方法连接右侧额部BIS监测。采取相同血浆浓度丙泊酚靶控输注,记录诱导前、切皮、去骨瓣、剪硬膜、切瘤、止血、睁眼时BIS值,比较两组BIS值差异是否存在统计学意义。结果两组病人人口学指标差异无统计学意义。相同血浆浓度下,血压、心率差异无统计学意义,颅内肿瘤组和椎管肿瘤组BIS值结果:诱导前(93.0±4.2 vs 92.8±4.1)、切皮后(39.3±7.3 vs 38.6±6.7)、去骨瓣(39.0±7.2 vs 39.1±6.1)、剪硬膜后(37.4±7.1 vs 39.7±7.4)、切瘤(38.8±8.2 vs 39.9±5.5)、止血(39.9±11.0 vs 41.5±5.2)、睁眼后(81.2±5.8 vs 80.8±4.6),两组差异均无统计学意义(P<0.05),相同丙泊酚血浆浓度下,颅脑和非颅脑手术病人BIS监测镇静深度结果差异无统计学意义。结论 BIS监测可以有效地应用于全身麻醉下颅内肿瘤病人手术中镇静深度监测。Objective To compare the difference of bispectral index （BIS） between intracranial tumor and non-intracranial tumor patients under general anesthesia with the same target-controlled infusion （TCI） propofol and to investigate the feasibility of BIS to monitor the sedation level of intracranial tumor patients under general anesthesia.Methods Twenty-five patients scheduled for elective intracranial tumor resection by under general anesthesia were enrolled in the study, ASA I-Ⅲ. And 25 subjects with spinal tumors were included as controls. We placed BIS sensor on the frontal area. The patients were anesthetized with the same TCI propofol and BIS values were collected before the induction of anesthesia, after incision, craniectomy, dura opening,during tumor resection,hemostasis,spontaneous eye opening. We compared the difference of BIS between intracranial tumor and non-intracranial tumor group. Results At the same Cp,BIS values were not statistically different between intracranial tumor group and non-intracranial tumor group：before induction of anesthesia（93.0±4.2 vs 92.8±4.1）;after incision（39.3±7.28 vs 38.6±6.7）; craniotomy （39.0±7.2 vs 39.1±6.1）; dura opening（37.4±7.1 vs 39.7±7.4）; during tumor resection （38.8±8.2 vs 39.9±5.5）; hemostasis（39.9±11.0 vs 41.5±5.2）; spontaneous eye opening（81.2±5.8 vs 80.8±4.6）. Conclusion The BIS values can accurately reflect the actual level of consciousness of intracranial tumor patients under general anesthesia with TCI propofol.

关 键 词：脑电双频指数 神经外科麻醉 脑电图 

分 类 号：R614[医药卫生—麻醉学]