Bruhn J, Kreuer S, Bischoff P, Kessler P, Schmidt G N, Grzesiak A, Wilhelm W
Department of Anaesthesiology and Intensive Care Medicine, University of Bonn, Germany.
Br J Anaesth. 2005 Jan;94(1):63-9. doi: 10.1093/bja/aei013. Epub 2004 Oct 29.
This study was designed to investigate the impact of bispectral index (BIS) or A-line AAI index (based on middle-latency auditory evoked potential) monitoring on recovery times and drug consumption when compared with standard anaesthetic practice during desflurane-remifentanil anaesthesia.
After having obtained approval from the institutional review board and written informed consent, 200 adult patients undergoing minor surgical procedures were randomized to receive a desflurane-remifentanil anaesthetic controlled either solely by clinical parameters or by BIS or AAI to the following target values: during maintenance of anaesthesia to a value of '50' (BIS) or '30' (AAI), 15 min before the end of surgery to '60' (BIS) or '45' (AAI). Recovery times and drug consumption were recorded by a blinded investigator.
Compared with standard practice, patients with BIS or AAI monitoring needed similar desflurane concentrations (standard practice 2.9 [0.5] vol%, BIS 3.3 [0.9] vol%, AAI 2.6 [0.5] vol%), and had similar recovery times (open eyes 5.6 [2.5] min, 5.9 [3.4] min, 5.0 [3.1] min; extubation 6.3 [2.4] min, 6.6 [3.5] min, 5.6 [3.0] min; stating name 7.3 [2.4] min, 7.6 [3.5] min, 7.3 [6.6] min).
Compared with standard anaesthetic practice BIS and AAI guided titration to the used target ranges did not result in a reduction of desflurane consumption or recovery times during minor surgery with use of remifentanil.
本研究旨在探讨与地氟醚-瑞芬太尼麻醉期间的标准麻醉实践相比，脑电双频指数（BIS）或A线听觉诱发电位指数（AAI，基于中潜伏期听觉诱发电位）监测对恢复时间和药物消耗量的影响。
在获得机构审查委员会的批准和书面知情同意后，将200例接受小型外科手术的成年患者随机分为三组，分别接受仅由临床参数控制、由BIS或AAI控制至以下目标值的地氟醚-瑞芬太尼麻醉：麻醉维持期间至“50”（BIS）或“30”（AAI），手术结束前15分钟至“60”（BIS）或“45”（AAI）。由一名不知情的研究者记录恢复时间和药物消耗量。
与标准实践相比，接受BIS或AAI监测的患者所需的地氟醚浓度相似（标准实践2.9 [0.5] vol%，BIS 3.3 [0.9] vol%，AAI 2.6 [0.5] vol%），恢复时间也相似（睁眼5.6 [2.5]分钟、5.9 [3.4]分钟、5.0 [3.1]分钟；拔管6.3 [2.4]分钟、6.6 [3.5]分钟、5.6 [3.0]分钟；说出姓名7.3 [2.4]分钟、7.6 [3.5]分钟、7.3 [6.6]分钟）。
与标准麻醉实践相比，在使用瑞芬太尼的小型手术中，将BIS和AAI滴定至所用目标范围并未导致地氟醚消耗量或恢复时间的减少。
