BIS监测下靶控输注异丙酚复合瑞芬太尼在全麻脑血管动脉瘤介入栓塞治疗中的临床观察  

Application of BIS-guided TCI with propofol and remifentanil for interventional embolization therapy of cerebral aneurysm

作　　者：杨燕 胡泉 YANG Yan;HU Quan(Department of Anesthesia The first people′s Hospital of Jiangxia District Hubei Province,Wuhan 430200,Chin)

机构地区：[1]湖北省武汉市江夏区第一人民医院麻醉科,武汉430200 [2]湖北省武汉市江夏区第一人民医院ICU,武汉430200

出　　处：《实用医学杂志》2018年第10期1705-1707,1711,共4页The Journal of Practical Medicine

摘　　要：目的评价脑电双频指数(BIS)指导靶控输注丙泊酚复合瑞芬太尼用于全麻脑血管动脉瘤介入术中的价值。方法将我院脑动脉瘤行介入术患者68例,采用随机分为两组:常规监测下靶控输注异丙酚复合瑞芬太尼组(A组,n=34),BIS监测下靶控输注异丙酚复合瑞芬太尼组(B组,n=34),A组凭临床经验及血流动力学变化控制麻醉深度,调整丙泊酚靶浓度,B组术中根据监测BIS值调整丙泊酚靶浓度,维持BIS值在45~60之间。记录两组的麻醉时间、术毕丙泊酚总用量、苏醒时间、拔除气管导管时间、麻醉恢复期低氧血症等发生情况,所有患者分别于术后24h进行回访,记录术中知晓及24h内恶心呕吐等的发生情况。结果两组比较,B组丙泊酚总用量减少明显(P<0.05),停药后苏醒时间及拔管时间均显著缩短(P<0.05)。在意识、潮气量和呼吸频率恢复方面B组患者更迅速,且低氧血症发生率低(P<0.05)。结论 BIS监测用于介入手术麻醉能提高手术安全性,精确预测麻醉效果、指导合理用药,对提高麻醉质量有较好的指导意义。Objective To investigate the value of BIS-guided TCI with propofol and remifentanil for inter-ventional embolization therapy of cerebral aneurysm. Methods Sixty-eight patients of both sexes undergoing elec-tive cerebral aneurysm embolization were randomly divided into two groups：Group A（TCl with propofol and remi-fentanil）,Group B（BIS-guided TCl with propofol and remifentanil）. Group A was adjusted the concentration ofpropofol depending on clinical experience and hemodynamic changes,while group B adjusted the concentration ofpropofol depending on BIS which was maintained between 45 to 60. The total anesthesia time and dosage of propo-fol,duration of recovery and extubation,the incidence of restlessness and hypoxemia at extubion were recorded. In-traoperative awareness and incidence of nausea and vomiting were also recorded as postoperative visiting after 24 hours. Results In comparison two groups,The total amount of propofol in group B decreased obviously（P〈0.05）,duration of recovery and extubation of group B was shorter（P〈0.05）. The recovery of consciousness,tid-al volume and respiratory rate of group B was faster than others. Incidence of hypoxemia was lower in group B（P 〈0.05）. Conclusion BIS-guided TCI with propofol and remifentanil for interventional,which can improve the sur-gical safety and anesthetic accuracy,is suitable for interventional embolization therapy of cerebral aneurysm.

关 键 词：BIS 异丙酚 介入栓塞术 全身麻醉 

分 类 号：R614.2[医药卫生—麻醉学]