脑电双频指数监测全身麻醉深度的临床评价

【】目的评价脑电双频指数（BIS）监测全身麻醉深度的准确性及实用性。方法2007年10月-2009年10月择期行腹腔镜胆囊切除手术的40例ASAⅠ或Ⅱ级患者随机平均分为A、B组，两组均采用丙泊酚、瑞芬太尼诱导和维持。A组以BIS值判断麻醉深度并指导调整用药，B组根据经验调整用药，使BIS值维持在50±5、MAP和HR维持在基础值±20%范围内。常规监测收缩压（SBP）、舒张压（DBP）、心率（HR）和BIS，计算用药总量，记录苏醒时间；诱导期进行改良警觉/镇静（OAA/S）评分，评价BIS对全身麻醉手术期间麻醉深度的监测和指导意义。结果麻醉期间，B组SBP、DBP、HR和BIS波动明显大于A组（P<0.05）；A组的苏醒时间（7.5±2.5）min明显短于B组（9.8±3.9）min（P<0.05）；拔管后，A组躁动、嗜睡、恶心、呕吐患者少于B组；A组无1例发生手术中知晓，B组1例发生手术中知晓。结论BIS可动态反映大脑生理功能的变化，有助于临床判断全身麻醉深度，指导麻醉用药。？【Abstract】ObjectiveToevaluatetheaccuracyandpracticalityofbispectralindex(BIS)usedinpatientsundergoinggeneralanesthesia.MethodsFortypatientsofASAclassⅠorⅡwererandomlydividedintogroupAandB,20patientsineachgroup.AnestheticdepthwasjudgedandanestheticswasadministeredbyBISmonitoring(beingkeptin50±5)ingroupAorbasedontheexperienceofanesthetistingroupB.Afteranesthesiainduction,targetpropofolandremifentanilconcentrationswereadjustedtomaintaintheMAP,HRwithintherangeof±20%ofpreinductionvalues.Systolicpressure(SBP),distolicpressure(DBP),HR,SpO2andBISweremonitored.Awaketimeandanestheticconsumptionwererecorded.ResultsThechangesofSBP,DBP,HRandBISwerelessingroupAthanthoseingroupB(P<0.05).AwaketimewasshorteringroupAthanthatingroupBandrestlessnessdrowsiness,nauseaandvomittingafterextubationwerelessingroupAthanthoseingroupB.NoawarenesspatientduringoperationwasseeningroupA,butonepatientsufferedfromawarenessingroupB.ConclusionBISmonitoringcandynamiclyreflectcerebralphysilologicalfunctionduringgeneralanesthesiaandishelpfulinjudginganesthesiadepthanddirectingtheadministrationofanesthetics.