氯胺酮和罗库溴铵对丙泊酚和瑞芬太尼稳态麻醉期间A线听觉诱发电位指数、脑电双频指数及熵指数监测值的影响。

The effects of ketamine and rocuronium on the A-Line auditory evoked potential index, Bispectral Index, and spectral entropy monitor during steady state propofol and remifentanil anesthesia.

作者信息

Vereecke Hugo E M, Vanluchene Ann L, Mortier Eric P, Everaert Karel, Struys Michel M R F

机构信息

Department of Anesthesiology, University Hospital, Ghent, Belgium.

出版信息

Anesthesiology. 2006 Dec;105(6):1122-34. doi: 10.1097/00000542-200612000-00012.

DOI:10.1097/00000542-200612000-00012

PMID:17122575

Abstract

BACKGROUND

The authors studied the effects of ketamine and rocuronium on the Bispectral Index, A-Line auditory evoked potential index, state entropy, and response entropy during a calculated steady state anesthesia with propofol and remifentanil.

METHODS

After ethics committee approval, 42 patients were allocated to four groups. Baseline measurements were performed after implementing a calculated steady state anesthesia with propofol and remifentanil. The control group received no additional medication. The ketamine group received a bolus and continuous infusion of ketamine. The rocuronium group received a bolus of rocuronium. The rocuronium-ketamine group received both. All data were stored during 15 min after baseline. After inspection of the raw data, the authors conducted an explorative statistical analysis.

RESULTS

No significant changes were found in the control group for any of the monitors. Mean values decreased in the rocuronium group for the A-Line auditory evoked potential index, Bispectral Index, and response entropy, but not for state entropy. In the ketamine group, the A-Line auditory evoked potential index and Bispectral Index did not change significantly, but state and response entropy increased. In the rocuronium-ketamine group, the A-Line auditory evoked potential index and Bispectral Index did not decrease as found in the rocuronium group. Response and state entropy increased significantly.

CONCLUSIONS

The response of all monitors after ketamine administration is not affected by simultaneous administration of rocuronium. Interpretation of all studied indices must be done cautiously while taking into account the clinical setting during measurement.

摘要

背景

作者研究了在丙泊酚和瑞芬太尼诱导的稳态麻醉期间，氯胺酮和罗库溴铵对脑电双频指数（Bispectral Index）、A线听觉诱发电位指数（A-Line auditory evoked potential index）、状态熵（state entropy）和反应熵（response entropy）的影响。

方法

经伦理委员会批准后，将42例患者分为四组。在实施丙泊酚和瑞芬太尼诱导的稳态麻醉后进行基线测量。对照组不给予额外药物。氯胺酮组给予氯胺酮单次推注及持续输注。罗库溴铵组给予罗库溴铵单次推注。罗库溴铵-氯胺酮组同时给予两者。所有数据在基线后15分钟内存储。在检查原始数据后，作者进行了探索性统计分析。

结果

对照组的任何监测指标均未发现显著变化。罗库溴铵组的A线听觉诱发电位指数、脑电双频指数和反应熵的平均值下降，但状态熵未下降。氯胺酮组的A线听觉诱发电位指数和脑电双频指数无显著变化，但状态熵和反应熵增加。在罗库溴铵-氯胺酮组中，A线听觉诱发电位指数和脑电双频指数并未像罗库溴铵组那样下降。反应熵和状态熵显著增加。