Paventi S, Santevecchi A, Metta E, Annetta M G, Perilli V, Sollazzi L, Ranieri R
Istituto di Anestesia e Rianimazione, Università Cattolica del Sacro Cuore, Rome, Italy.
Minerva Anestesiol. 2001 Jun;67(6):435-9.
Recent studies have suggested that electroencephalogram bispectral index (BIS) monitoring can improve recovery after anaesthesia and save money by shortening patients postoperative stay. The aim of the study is to evaluate the management of drugs and to measure immediate recovery after anaesthesia with or without BIS monitoring.
We studied 90 patients undergoing abdominal surgery randomly allocated to one of two groups of 45 each with or without BIS monitoring. Standard monitoring (EKG, arterial oxygen saturation and non-invasive blood pressure) was applied. All groups were monitored with BIS, using electrodes (Zipprep, Aspect Medical Systems) applied to the forehead. In the group 2 the BIS value was blinded to the anaesthesiologist. The BIS value was displayed using Spacelabs Medical BIS Ultraview Monitor. After obtaining baseline values for the BIS index (group 1) and haemodynamic data (all groups) anaesthesia was induced with a bolus dose of remifentanil and TPS, and vecuronium. The anaesthesia was maintained with Remifentanil and Sevoflurane. At standard times BIS, haemodynamic and respiratory parameters were recorded. Recovery times were measured by a study coordinator. Drug consumption was calculated.
In group 1 the consumption of Sevoflurane decreased by 40 % while the consumption of remifentanil decreased by 10 % as compared to group 2. The use of vecuronium did not change in the 2 groups. In group 1 the time elapsed from cessation of anaesthetics to orientation decreased significantly. The difference was 5 min, from 11 to 6 min.
BIS monitoring decrease both sevoflurane and remifentanil consumption, when compared to anaesthesia without BIS, with an immediate recovery after sevoflurane and remifentanil anaesthesia.
近期研究表明，脑电图双谱指数（BIS）监测可改善麻醉后的恢复情况，并通过缩短患者术后住院时间节省费用。本研究的目的是评估药物管理情况，并测量有无BIS监测时麻醉后的即时恢复情况。
我们研究了90例行腹部手术的患者，随机分为两组，每组45例，分别进行有或无BIS监测。采用标准监测（心电图、动脉血氧饱和度和无创血压）。所有组均使用贴于前额的电极（Zipprep，Aspect Medical Systems）进行BIS监测。在第2组中，BIS值对麻醉医生保密。使用Spacelabs Medical BIS Ultraview Monitor显示BIS值。在获得BIS指数的基线值（第1组）和血流动力学数据（所有组）后，静脉推注瑞芬太尼、丙泊酚和维库溴铵诱导麻醉。麻醉维持采用瑞芬太尼和七氟醚。在标准时间记录BIS、血流动力学和呼吸参数。由研究协调员测量恢复时间。计算药物消耗量。
与第2组相比，第1组七氟醚消耗量减少40%，瑞芬太尼消耗量减少10%。两组维库溴铵的使用量没有变化。在第1组中，从停止麻醉到苏醒的时间显著缩短。差异为5分钟，从11分钟降至6分钟。
与无BIS监测的麻醉相比，BIS监测可减少七氟醚和瑞芬太尼的消耗量，七氟醚和瑞芬太尼麻醉后可即时恢复。
