脑电双频指数监测复合喉罩通气在输尿管软镜碎石术中的应用研究  

Study on application of bispectral index monitoring combined with laryngeal mask ventilation in flexible ureteroscopic lithotripsy

作　　者：黄世峰 莫增密 武贵林 罗承昌 HUANG Shi-feng;MO Zeng-mi;WU Gui-lin(Department of Anesthesiology,923 Hospital of PLA Joint Service Support Force,Nanning 530021,China)

机构地区：[1]解放军联勤保障部队第923医院麻醉科,530021 [2]解放军联勤保障部队第923医院泌尿外科,530021

出　　处：《中国实用医药》2023年第5期64-66,共3页China Practical Medicine

基　　金：广西卫健委自筹经费科研课题(项目编号:Z-A20221020)。

摘　　要：目的评价脑电双频指数(BIS)监测复合喉罩通气在输尿管软镜碎石术中的应用效果。方法92例择期行输尿管软镜碎石术患者,采用随机数字表法分为对照组和BIS监测组,每组46例。两组均采用静脉全身麻醉,BIS监测组采用BIS监测复合喉罩通气,对照组根据麻醉师经验监测麻醉深度及气管插管通气。比较两组术中麻醉药用量、术后苏醒质量指标及术后麻醉相关不良事件发生情况。结果BIS监测组患者丙泊酚用量为(4.95±0.49)mg/kg、罗库溴铵用量为(0.16±0.03)mg/kg、瑞芬太尼用量为(0.17±0.03)μg/kg,均少于对照组的(7.15±1.00)mg/kg、(0.19±0.05)mg/kg、(0.25±0.04)μg/kg,差异均有统计学意义(P<0.05)。BIS监测组术后自主呼吸恢复时间为(6.19±1.70)min、意识苏醒时间为(4.45±1.29)min、拔除通气装置时间为(1.50±0.60)min、麻醉后监测治疗室(PACU)监测时间为(19.45±5.30)min,均短于对照组的(10.76±2.62)、(9.36±2.71)、(2.38±1.25)、(32.48±6.53)min,差异均有统计学意义(P<0.05)。BIS监测组术后麻醉相关不良事件发生率为4.35%,低于对照组的17.39%。差异有统计学意义(P<0.05)。结论行输尿管软镜碎石术时,BIS监测复合喉罩通气可减少术中麻醉药物用量,提高患者术后苏醒质量,缩短拔除通气装置和PACU监测时间,降低围术期麻醉风险,提高麻醉管理水平。Objective To evaluate the practical effects of bispectral index(BIS)monitoring combined with laryngeal mask ventilation in flexible ureteroscopic lithotripsy.Methods A total of 92 patients undergoing elective flexible ureteroscopic lithotripsy were randomly divided into control group and BIS monitoring group,with 46 cases in each group.Both groups received intravenous general anesthesia.BIS monitoring group used BIS and laryngeal mask ventilation,and control group received anesthesia depth monitoring and tracheal intubation ventilation according to anesthesiologist experience.The intraoperative anesthetic dosage,postoperative recovery indexes and incidence of anestesia related adverse events were compared between the two groups.Results In BIS monitoring group,the dosage of propofol,rocuronium and remifentanil were(4.95±0.49)mg/kg,(0.16±0.03)mg/kg and(0.17±0.03)μg/kg,which were lower than(7.15±1.00)mg/kg,(0.19±0.05)mg/kg and(0.25±0.04)μg/kg in the control group,and the differences were statistically significant(P<0.05).The recovery time of spontaneous breathing,consciousness recovery time,ventilation device removal time and PACU monitoring time in the BIS monitoring group were(6.19±1.70)min,(4.45±1.29)min,(1.50±0.60)min and(19.45±5.30)min,which were shorter than(10.76±2.62),(9.36±2.71),(2.38±1.25)and(32.48±6.53)min in the control group,and the differences were statistically significant(P<0.05).The incidence of anestesia related adverse events was 4.35%in the BIS monitoring group,which was lower than 17.39%in the control group,and the difference was statistically significant(P<0.05).Conclusion During the flexible ureteroscopic lithotripsy,BIS monitoring combined with laryngeal mask ventilation can reduce the amount of intraoperative anesthetic dosage,improve the quality of postoperative recovery,shorten the time of ventilator removal and PACU monitoring,reduce the risk of perioperative anesthesia and improve the level of anesthesia management.

关 键 词：脑电双频指数 喉罩 麻醉监测 输尿管软镜碎石术 麻醉深度 

分 类 号：R614[医药卫生—麻醉学]