脑电双频谱指数监测在老年患者全凭静脉麻醉下腹腔镜手术中的应用  

Application of bispectral index monitoring in laparoscopic surgery for elderly patients under total intravenous anesthesia

作　　者：黄梁淘 陈春霞[1] 方巧婵 Huang Liangtao;Chen Chunxia;Fang Qiaochan(Department of Anesthesiology,Houjie Hospital of Dongguan,Guangdong Province,523940,China)

机构地区：[1]东莞市厚街医院麻醉科,广东省523940

出　　处：《现代电生理学杂志》2021年第2期94-97,共4页Journal of Modern Electrophysiology

摘　　要：目的:脑电双频谱指数(BIS)监测在老年患者全凭静脉麻醉下腹腔镜手术中的应用。方法:选择2019年4月至2020年4月于东莞市厚街医院接受全凭静脉麻醉下腹腔镜手术治疗的84例老年患者,性别不限,年龄60~79岁,采用随机数字表法将患者分为对照组和观察组,每组42例。对照组患者术中进行常规生命体征监测,观察组接受BIS监测。观察两组患者手术麻醉情况、血流动力学情况、脑电熵指数以及诱发电位异常情况。结果:观察组苏醒时间、拔管时间以及麻醉后监测治疗室(PACU)监测时间均短于对照组,丙泊酚用量少于对照组,差异有统计学意义(P<0.05)。插管前两组患者收缩压、舒张压、心率以及平均动脉压水平比较差异无统计学意义(P>0.05);插管后,观察组上述各指标水平均低于对照组,差异有统计学意义(P<0.05)。插管前两组患者反应熵(RE)、状态熵(SE)水平比较差异无统计学意义(P>0.05);插管后观察组RE、SE低于对照组,且观察组体感诱发电位及脑干听觉诱发电位异常率均小于对照组,差异均有统计学意义(P<0.05)。结论:BIS监测用于老年患者全凭静脉麻醉下腹腔镜手术能有效调节术中麻醉深度,稳定患者血流动力学,减少丙泊酚用量,缩短患者苏醒时间。Objective:To explore the application of bispectral index monitoring in laparoscopic surgery for elderly patients under total intravenous anesthesia.Methods:A total of 84 elderly patients,aged 60-79 years old,both of sexes,who received laparoscopic surgery under total intravenous anesthesia in Houjie Hospital of Dongguan from April 2019 to April 2020,were divided into control group and observation group by random number table method,with 42 cases in each group.Patients in the control group received routine vital signs monitoring during operation,while patients in the observation group received BIS monitoring.Anesthesia,hemodynamics,EEG entropy index and abnormal evoked potential were observed.Results:The recovery time,extubation time and PACU monitoring time in the observation group were shorter than those in the control group,and the propofol dosage was less than that in the control group,with statistical significance(P<0.05).There was no significant difference in systolic blood pressure,diastolic blood pressure,heart rate and mean arterial pressure between the two groups before intubation(P>0.05).After intubation,the above indexes in the observation group were lower than those in the control group(P<0.05).There was no significant difference in reaction entropy(RE)and state entropy(SE)between the two groups before intubation(P>0.05).After intubation,RE and SE in the observation group were lower than those in the control group,and the abnormal rates of somatosensory evoked potential and brainstem auditory evoked potential in the observation group were lower than those in the control group(P<0.05).Conclusion:BIS monitoring can effectively adjust the depth of anesthesia in laparoscopic surgery for elderly patients under total intravenous anesthesia,stabilize the hemodynamics,reduce the dosage of propofol and shorten the recovery time.

关 键 词：脑电描记术 麻醉药 全身 电生理学 腹腔镜 

分 类 号：R614[医药卫生—麻醉学]