双频指数和听觉诱发电位在监测麻醉深度中的价值  

Assessment of anesthetic depth by bispectral index and auditory evoked potentials

作　　者：许海芳[1] 董榕[1] 任凤珍[1] 沈永倩[1] 于布为[1] 

机构地区：[1]上海第二医科大学附属瑞金医院麻醉科,200025

出　　处：《临床麻醉学杂志》2002年第11期577-580,共4页Journal of Clinical Anesthesiology

摘　　要：目的　评估脑电双频指数 (BIS)和中潜伏期听觉诱发电位 (MLAEP)在监测麻醉深度中的价值。方法　 2 1例择期手术患者随机分为Ⅰ组 (对照组 ,n =11)和Ⅱ组 (咪唑安定组 ,n =10 ) ,输入复方乳酸钠液 10ml/kg后 ,以 0 4mg·kg-1·min-1的速度静脉推注丙泊酚 2mg/kg ,在诱导第 4分钟注入维库溴铵 0 1mg/kg、芬太尼 2 μg/kg ,Ⅱ组同时注入咪唑安定 0 0 4mg/kg。记录OAA/S镇静评分、收缩压、舒张压、心率、BIS和反映MLAEP的ARX指数 (ARX Index ,AAI)的基础值 ,以及诱导插管时每分钟的数值。结果　 (1)AAI反应时间较BIS显著缩短 (P <0 0 5 ) ;(2 )OAA/S镇静评分与BIS、AAI显著相关 (r =0 86 0 2、0 85 5 0 ,P <0 0 1) ;(3)Ⅱ组注入咪唑安定后 1分钟 ,AAI较Ⅰ组显著下降 (P <0 0 5 ) ;2分钟后 ,BIS较Ⅰ组显著下降 (P =0 0 0 1) ;(4)Ⅰ组的插管反应大于Ⅱ组 ,插管即刻AAI差异显著 (P =0 0 1) ,插管后 1分钟BIS差异显著 (P <0 0 5 ) ;Ⅱ组在插管前后AAI和BIS均无显著差异。结论　 (1)AAI和BIS均能反映镇静程度和插管反应 ,但AAI反应更快 ,趋于实时监测 ;(2 )Objective To evaluate the validity of assessing anesthetic depth by bispectral index(BIS)and middle latency auditory evoked potentials(MLAEP).Methods Twenty one patients for elective surgery were randomly assigned to group Ⅰ(control group, n= 11)and group Ⅱ(midazolam group, n= 10).After infusion of RL 10ml/kg,propofol 2mg/kg was given intravenously at 0 4mg·kg -1 ·min -1 .At the fourth minute of slow induction,vecuronium 0 1mg/kg and fentanyl 2μg/kg was infused,and midazolam 0 04mg/kg was introduced meantime in group Ⅱ.OAA/S sedation score,systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),BIS and ARX Index(AAI) which reflect MLAEP were recorded at baseline and every other minute after induction.Results (1)The responsive time of AAI was shorter than that of BIS( P< 0 05);(2)OAA/S sedation score correlated well with BIS and AAI( r= 0 8602 and 0 8550 respectively,both of P< 0 01);(3)one minute after infusion of midazolam,AAI in group Ⅱ decreased markedly than in group Ⅰ( P< 0 05) while BIS showed significant difference at the second minute( P< 0 01);(4)the degree of intubation stimuli was greater in group Ⅰ,AAI increased singificantly in group Ⅰ with intubation stimuli( P= 0 005) while BIS showed difference one minute later.Conclusion (1)Both AAI and BIS can reflect sedation scale and intubation stimuli degree,but AAI responds quicker,tends to monitor on real time;(2)Combinative administration of midazola may inhibit intubation stimuli. [

关 键 词：全身麻醉 听觉诱发电位 双频指数 麻醉监测 

分 类 号：R614[医药卫生—麻醉学]