Başar H, Ozcan S, Buyukkocak U, Akpinar S, Apan A
Kirikkale University, Department of Anaesthesiology and Reanimation, Kirikkale, Turkey.
Eur J Anaesthesiol. 2003 May;20(5):396-400.
The bispectral index, a parameter derived from the electroencephalograph, has been shown to correlate with the loss of consciousness and sedation. This study was designed to assess the effects of bispectral index monitoring on sevoflurane and its recovery profiles.
Sixty ASA I and II patients undergoing open abdominal surgery were randomized into two groups: one monitored using the bispectral index (Group BIS) and the other without its use (controls). After a standardized induction, anaesthesia was maintained with sevoflurane in both groups. In Group BIS, sevoflurane was titrated to maintain the bispectral index in the range 40-60. In the control group, the administered sevoflurane concentration was adjusted according to the signs of anaesthesia. The end-tidal sevoflurane concentration, bispectral index and routine haemodynamic variables were noted every 5 min during surgery. The consumption of sevoflurane was computed. At the conclusion of surgery operations, the time to 'open eyes on verbal command', 'motor response to verbal command' and Aldrete's score were recorded by a blinded anaesthesiologist.
The difference in the consumption of sevoflurane was not significant between the groups. Bispectral index monitoring was associated with a reduction of 4.73% in sevoflurane usage and 2.19 mL h(-1) was saved.
Bispectral index monitoring during anaesthesia provides only a small advantage related to the need to monitor the depth of anaesthesia.
脑电双频指数是一种从脑电图得出的参数,已被证明与意识丧失和镇静相关。本研究旨在评估脑电双频指数监测对七氟醚及其恢复情况的影响。
60例接受腹部开放手术的美国麻醉医师协会(ASA)分级为I级和II级的患者被随机分为两组:一组使用脑电双频指数进行监测(BIS组),另一组不使用(对照组)。在进行标准化诱导后,两组均用七氟醚维持麻醉。在BIS组中,调整七氟醚剂量以使脑电双频指数维持在40 - 60范围内。在对照组中,根据麻醉体征调整七氟醚给药浓度。手术期间每5分钟记录呼气末七氟醚浓度、脑电双频指数和常规血流动力学变量。计算七氟醚的消耗量。手术结束时,由一位不知情的麻醉医师记录“对言语指令睁眼”“对言语指令的运动反应”时间以及Aldrete评分。
两组之间七氟醚消耗量的差异不显著。脑电双频指数监测使七氟醚用量减少了4.73%,节省了2.19 mL·h⁻¹。
麻醉期间的脑电双频指数监测在监测麻醉深度方面仅提供了微小优势。