Tufano R, Palomba R, Lambiase G, Giurleo L G
Dipartimento Universitario di Scienze Chirurgiche Anestesiologiche-Rianimatorie dell'Emergenza, Facoltà di Medicina e Chirurgia, Università degli Studi Federico I, Napoli.
Minerva Anestesiol. 2000 May;66(5):389-93.
The Bispectral Index (BIS), a parameter derived from the electroencephalograph, has been shown to correlate with increasing sedation and loss of consciousness. This study was designed to investigate whether using BIS would improve anaesthetic drug management and immediate recovery after anaesthesia.
160 patients undergoing abdominal surgery were studied. The patients were randomised to receive either propofol or sevoflurane anaesthesia. In each group 40 patients were anaesthetised with BIS monitoring and 40 without BIS. In BIS groups, propofol and sevoflurane dose was adjusted to achieve a target BIS values between 40-60 during the whole procedure. Drug consumption, intraoperative responses, times of recovery after anaesthesia and a "Clinical Quality Scale of Recovery" score were recorded from blinded observators.
Demographic data were similar between groups. BIS monitoring improved the immediate recovery after propofol anaesthesia, while no significant differences were observed in patients receiving sevoflurane. The consumption of both propofol and sevoflurane significantly decreased (30 and 40%, respectively). There was no significant differences in the incidence of intraoperative responses between groups. The BIS groups had a higher percentage of patients with better ICU assessments.
BIS monitoring decreased the consumption of both propofol and sevoflurane and facilitated the immediate recovery after propofol anaesthesia. Intraoperative course was not changed. These findings indicate that the use of BIS may be a valuable guide of the intraoperatively administration of propofol and sevoflurane.
脑电双频指数(BIS)是一种从脑电图得出的参数,已被证明与镇静加深和意识丧失相关。本研究旨在调查使用BIS是否会改善麻醉药物管理及麻醉后的即时恢复情况。
对160例接受腹部手术的患者进行研究。患者被随机分为接受丙泊酚或七氟醚麻醉。每组中40例患者在BIS监测下进行麻醉,40例患者不进行BIS监测。在BIS监测组中,调整丙泊酚和七氟醚剂量,以使整个手术过程中的目标BIS值维持在40 - 60之间。由不知情的观察者记录药物消耗量、术中反应、麻醉后恢复时间以及“恢复临床质量量表”评分。
各组间人口统计学数据相似。BIS监测改善了丙泊酚麻醉后的即时恢复情况,而在接受七氟醚麻醉的患者中未观察到显著差异。丙泊酚和七氟醚的消耗量均显著降低(分别降低30%和40%)。各组间术中反应发生率无显著差异。BIS监测组中ICU评估较好的患者比例更高。
BIS监测降低了丙泊酚和七氟醚的消耗量,并促进了丙泊酚麻醉后的即时恢复。术中过程未改变。这些发现表明,使用BIS可能是术中给予丙泊酚和七氟醚的有价值的指导。