[脑电双频指数（BIS）和听觉诱发电位指数（AEPindex）监测对静吸复合麻醉中麻醉深度的影响]

[Effects of BIS and AEPindex monitoring on the depth of anesthesia in in intravenous-inhalational anesthesia anesthesia].

作者信息

Yang Hao-Bo, Guo Qu-Lian

机构信息

Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha 410008, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2007 Feb;32(1):127-31.

PMID:17344602

Abstract

OBJECTIVE

To evaluate the effects of bispectral index(BIS) and auditory evoked potentials index(AEPindex) monitoring on the depth of anesthesia in inhalation of isoflurane and target-controlled infusion(TCI) of propofol, and to observe the changes of BIS and AEPindex.

METHODS

Fourty ASA physical status I - II patients undergoing selective abdominal operations were divided into 2 groups randomly: Group I1(the end-tidal isoflurane concentration was 0.6 MAC, n=20) and Group I2(the end-tidal isoflurane concentration was 1.0 MAC, n=20). Anesthesia was induced with proprofol and vecuroninm. After the tracheal intubation, the patients were ventilated with 0.6/1.0 MAC isoflurane in pure oxygen, and after 20 minutes, propofol was administered with TCI according to the different target plasma concentrations from 1.0 g/mL to 3.0 g/mL(increasing 0.5 g/mL each time). The changes of MAP, HR, BIS and AEPindex were recorded simultaneously.

RESULTS

There was no close correlation between MAP, HR and the end-tidal isoflurane concentration, target plasma concentration of propofol. The correlation coefficiencies between BIS, AEPindex and the end-tidal isoflurane concentration were -0.757, -0.819 and -0.832, -0.878 (P<0.001), respectively; those between BIS, AEPindex and the target plasma concentration of propofol were -0.932, -0.888 and -0.920, -0.923 (P<0.001). The correlation coefficiencies between BIS, AEPindex and the stimulation of endotracheal intubation were -0.728 and 0.544, respectively; however, there was no close correlation between BIS , AEPindex and the stimulation of skin incision, and exploration.

CONCLUSION

BIS and AEPindex are reliable parameters to monitor the depth of anesthesia of isoflurane and propofol combined anesthesia; and in response to the stimulation of tracheal intubation, AEPindex is better than BIS, but BIS and AEPindex can not be used to predict the cardiovascular reaction of skin incision and exploration.

摘要

目的

评价脑电双频指数（BIS）和听觉诱发电位指数（AEPindex）监测在异氟烷吸入和丙泊酚靶控输注（TCI）麻醉中对麻醉深度的影响，并观察BIS和AEPindex的变化。

方法

40例美国麻醉医师协会（ASA）身体状况Ⅰ-Ⅱ级择期腹部手术患者随机分为2组：Ⅰ1组（呼气末异氟烷浓度为0.6MAC，n = 20）和Ⅰ2组（呼气末异氟烷浓度为1.0MAC，n = 20）。用丙泊酚和维库溴铵诱导麻醉。气管插管后，患者在纯氧中用0.6/1.0MAC异氟烷通气，20分钟后，根据不同的靶血浆浓度从1.0μg/mL至3.0μg/mL（每次增加0.5μg/mL）用TCI给予丙泊酚。同时记录平均动脉压（MAP）、心率（HR）、BIS和AEPindex的变化。

结果

MAP、HR与呼气末异氟烷浓度、丙泊酚靶血浆浓度之间无密切相关性。BIS、AEPindex与呼气末异氟烷浓度之间的相关系数分别为-0.757、-0.819和-0.832、-0.878（P<0.001）；BIS、AEPindex与丙泊酚靶血浆浓度之间的相关系数分别为-0.932、-0.888和-0.920、-0.923（P<0.001）。BIS、AEPindex与气管插管刺激之间的相关系数分别为-0.728和0.544；然而，BIS、AEPindex与皮肤切开和探查刺激之间无密切相关性。