Ishiyama Tadahiko, Kashimoto Satoshi, Oguchi Takeshi, Yamaguchi Toshiaki, Okuyama Katsumi, Kumazawa Teruo
Department of Anesthesiology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.
Anesth Analg. 2005 Mar;100(3):728-732. doi: 10.1213/01.ANE.0000159868.06847.47.
The sedative effects of epidural anesthesia without volatile and IV anesthetics and quantification of the degree of epidural anesthesia-induced sedation have not been investigated. In the current study we evaluated the effects of epidural anesthesia on the bispectral index (BIS) during the awake phase and during general anesthesia. After placing the epidural catheter, the patients were randomly allocated to 2 groups receiving either 5 mL of epidural saline (group S) or the same volume of 0.75% ropivacaine (group R). The BIS measurements during the awake phase were performed at 7, 12, 13, 14, 22, and 23 min after the epidural injection. General anesthesia was then induced with propofol and vecuronium and maintained with 0.75% sevoflurane. From approximately 10 min after tracheal intubation, the BIS measurements were made at 1-min intervals for 10 min. The BIS during the awake phase was significantly lower in group R than in group S (P < 0.05). The BIS during general anesthesia was significantly lower in group R than in group S (P < 0.0001). Epidural anesthesia decreased the BIS during the awake phase and during general anesthesia. The decrease of the BIS associated with epidural anesthesia was more prominent during general anesthesia than during the awake phase.
未使用挥发性麻醉药和静脉麻醉药的硬膜外麻醉的镇静效果以及硬膜外麻醉诱导镇静程度的量化尚未得到研究。在本研究中，我们评估了硬膜外麻醉对清醒期和全身麻醉期间脑电双频指数（BIS）的影响。放置硬膜外导管后，将患者随机分为2组，分别接受5 mL硬膜外生理盐水（S组）或相同体积的0.75%罗哌卡因（R组）。在硬膜外注射后7、12、13、14、22和23分钟进行清醒期的BIS测量。然后用丙泊酚和维库溴铵诱导全身麻醉，并用0.75%七氟醚维持。从气管插管后约10分钟开始，每隔1分钟进行10分钟的BIS测量。R组清醒期的BIS显著低于S组（P < 0.05）。全身麻醉期间R组的BIS显著低于S组（P < 0.0001）。硬膜外麻醉降低了清醒期和全身麻醉期间的BIS。与硬膜外麻醉相关的BIS降低在全身麻醉期间比清醒期更明显。
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