熵指数与脑电双频指数监测全麻患者体位变化时镇静深度的比较  

The effects of postural factor on the Entropy index and the Bispectral index of patients with general anesthesia

作　　者：钟燕婷[1] 吴论[2] 朱小兵[2] 夏莹[2] ZHONG Yanting;WU Lun;ZHU Xiaobing;XIA Ying(Medical Department of Graduate school of Guangzhou University of Chinese Medine,Guangzhou 510000 Guangdong,China;Department of Anesthesiology, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan 528400, China)

机构地区：[1]广州中医药大学研究生院,广州510000 [2]广东省中山市中医院麻醉科,广东中山528400

出　　处：《现代仪器与医疗》2017年第1期33-34,67,共3页Modern Instruments & Medical Treatment

基　　金：中山市科技计划项目(No:2015B1044)

摘　　要：目的 :观察熵指数和脑电双频指数监测体位变化患者镇静深度的准确性。方法 :择期行全麻手术患者120例,年龄25~55岁,BMI 18~24kg/m^2,ASA分级Ⅰ级或Ⅱ级。无肌松药下丙泊酚复合瑞芬太尼靶控输注诱导气管插管。待维持稳态靶控浓度后10min,将患者置于平卧位、头低脚高位30°、平卧位、头高脚低位30°。每个体位保持15min,间隔5min记录反应熵(RE)、状态熵(SE)、BIS值及HR、MAP、ETCO_2、SpO_2。结果 :两次平卧位BIS、SE、RE值比较,差异无统计学意义;与平卧位比较,头低脚高位BIS、SE值显著升高(P<0.05),RE值差异无统计学意义;与平卧位比较,头高脚低位BIS、SE值显著降低(P<0.05),RE值差异无统计学意义;与头低脚高位比较,头高脚低位BIS、SE值显著降低(P<0.05),RE值差异无统计学意义。结论 :体位因素对熵指数的影响小于对脑电双频指数的影响,与脑电双频指数相比,熵指数用于手术患者体位变化时麻醉深度监测更准确。Objective: To evaluated the accuracy of Entropy index and Bispectral index when they were used for monitoring the depth of anesthesia of patients with different positions. Methods: 120 cases were enrolled in this study.Anesthsia was induced with propofol-remifentanil given by target controlled infusion. After maintaining steady state target controlled concentration for 10minutes, the patient position was then resetted to horizontal position, head-down position, horizontal position and head-up position. Each kind of positon was keeped 15min, the datas were recorded at 5min interals for 3 readings. Results: The values of BIS and SE of head-down position are much higher than the horizontal position, these stepwise difference in RE values are unsignificant. The values of BIS and SE of head-up position are much lower than the horizontal position(P<0.05), these stepwise difference in RE values are unsignificant.Compared with the head-down position,the values of BIS and SE of head-up position are much lower(P<0.05), these stepwise difference in RE values are unsignificant. Conclusion: The influence of postural factor on the Entropy index was less than on the Bispectral index. Compared with BIS, Entropy index was more accurate for the inperprtation of the patient who needs to change the position.

关 键 词：麻醉深度 脑电双频指数 熵指数 体位因素 

分 类 号：R614[医药卫生—麻醉学]