BIS监测下浅全麻在夹层动脉瘤腔内隔绝术中的应用  

APPLICATION OF LIGHT GENERAL ANESTHESIA UNDER BIS MONITORING IN ENDOVASCULAR EXCLUSION OF DISSECTING ANEURYSM

作　　者：刘晓丽 王伟伟 陶永忠 LIU Xiaoli;WANG Weiwei;TAO Yongzhong(Department of Anesthesiology,Subei Hospital,Yangzhou,Yangzhou 225000,China)

机构地区：[1]江苏省扬州市苏北人民医院麻醉科,225000

出　　处：《中国煤炭工业医学杂志》2022年第6期576-579,共4页Chinese Journal of Coal Industry Medicine

基　　金：江苏省卫生健康委员会医学科研项目(编号:H2019068);江苏省苏北人民医院院级课题项目(编号:yzucms201811)。

摘　　要：目的 研究BIS监测下精简全麻(全麻诱导药量减量且麻醉维持药物种类减少)在主动脉瘤腔内隔绝术(血管内主动脉修复术)中的应用。方法 选择主动脉夹层择期行介入下主动脉腔内隔绝术患者54例,随机分为精简组和常规组,每组27例。常规组(Ⅰ组)全麻插入气管导管,常规维持;精简组(Ⅱ组)采用全麻置入喉罩,诱导药量减量,维持药物减少。记录患者手术中各时间点BIS值、平均动脉压(MAP)、心率(HR)等指标。记录二组拔管期呛咳、躁动等拔管反应,以及术后随访患者有无术中知晓。结果 常规组(Ⅰ组)麻醉诱导、插管及拔管期血流动力学波动高于精简组(Ⅱ组);严重呛咳、躁动例数高于精简组(Ⅱ组);二组在BIS监测下维持合适的麻醉深度,术后随访均未出现术中知晓。结论 喉罩精简全麻用于夹层动脉瘤腔内隔绝术安全可靠,比常规气管插管全麻更平稳。Objective We aimed to interrogate the effects of simplified general anesthesia under BIS monitoring in endovascular aortic repair(EVAR).Methods We randomized fifty-four patients with aortic dissection who were randomly assigned into two groups.The simplified general anesthesia group(n=27) and Control group(n=27).We used tracheal intubation and conventional general anesthetic drugs in the Control group(Group Ⅰ).In contrast,we used laryngeal mask airway(LMA) and anesthetic drug reduction in the simplified Group(Group Ⅱ).Besides,we measured the BIS value,mean arterial pressure(MAP),heart rate(HR) at different time points during the operation.Simultaneously,we recorded the extubation reactions such as coughing and restlessness in the two groups.We also recorded the patients if they occurred intraoperative awareness.Results Our data showed a significant difference in the hemodynamic fluctuation during anesthesia induction,intubation,and extubation between Group Ⅰ and Group Ⅱ(P<0.05).The number of severe cough and agitation cases in Group I was higher than in Group II.Both groups maintained appropriate anesthesia depth under BIS monitoring,and no intraoperative awareness was found during follow-up.Conclusion Simplified general anesthesia with laryngeal mask airway is more secure and stable than conventional general anesthesia with tracheal intubation.

关 键 词：精简全麻 喉罩 BIS EVAR 

分 类 号：R87[医药卫生—运动医学]