Yang Na, Ge Ming-fei, Wang Tian-long, Wu Xiao-guang
Department of Anesthesiology, Affiliated Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Zhonghua Yi Xue Za Zhi. 2011 Nov 1;91(40):2849-52.
To evaluate the value of wavelet index (WLI) in general anesthesia through a comparison of WLI with bispectral index (BIS).
A total of 53 patients scheduled for elective surgery with ASA (American Society of Anesthesiologists) I-II were selected to undergo general anesthesia. The monitoring probes of BIS, WLI and muscle relaxation were connected in awaking patients. The values of WLI and BIS were recorded at 10 min (T₁) entering OR (operating room), immediate before anesthesia induction (T₂), when the OAA/S (observer's assessment of alertness/sedation) score declined gradually to 5(T₃), 4(T₄), 3(T₅), 2(T₆), 1(T₇) after the infusion of propofol, after vecuronium given when the TOF value decreased to 100 (T₈), 75(T₉), 50 (T₁₀), 25 (T₁₁), 0 (T₁₂) after the injection of vecuronium, tracheal intubation (T₁₃), 1 min (T₁₄), 3 min (T₁₅) and 5 min (T₁₆) after the completion of tracheal intubation, immediate before initiating surgical procedure (T₁₇), beginning the operation (T₁₈), 1 min (T₁₉), 3 min (T₂₀), 5 min (T₂₁) post-operation, skin suturing (T₂₂), end of surgery (T₂₃), tracheal extubation (T₂₄), 1 min (T₂₅) and 5 min (T₂₆)cd post-extubation, immediate before exiting OR (T₂₇).
The value of WLI at T₁₀-T₁₃, T₂₂-T₂₇ was more than BIS (P < 0.05). The Bland-Altman analysis showed that WLI was accepted comparing with BIS during the period of anesthesia. The bias was -2.99, 95% limits of agreement -29.97% to 21.56%. The correlation coefficients of OAA/S score with BIS and WLI were: r(BIS) = 0.884, r(WLI) = 0.757 (P = 0.000).
WLI index is feasible for monitoring the depth of general anesthesia.
通过比较小波指数(WLI)与脑电双频指数(BIS),评估WLI在全身麻醉中的价值。
选取53例拟行择期手术的美国麻醉医师协会(ASA)Ⅰ-Ⅱ级患者,实施全身麻醉。在清醒患者身上连接BIS、WLI及肌肉松弛监测探头。记录进入手术室(OR)10分钟(T₁)、麻醉诱导前即刻(T₂)、输注丙泊酚后观察到警觉/镇静(OAA/S)评分逐渐降至5(T₃)、4(T₄)、3(T₅)、2(T₆)、1(T₇)时、注射维库溴铵后当四个成串刺激(TOF)值降至100(T₈)、75(T₉)、50(T₁₀)、25(T₁₁)、0(T₁₂)时、气管插管时(T₁₃)、气管插管完成后1分钟(T₁₄)、3分钟(T₁₅)和5分钟(T₁₆)、开始手术前即刻(T₁₇)、开始手术时(T₁₈)、术后1分钟(T₁₉)、3分钟(T₂₀)、5分钟(T₂₁)、皮肤缝合时(T₂₂)、手术结束时(T₂₃)、气管拔管时(T₂₄)、拔管后1分钟(T₂₅)和5分钟(T₂₆)、离开OR前即刻(T₂₇)时的WLI和BIS值。
T₁₀-T₁₃、T₂₂-T₂₇时WLI值高于BIS(P<0.05)。Bland-Altman分析显示,在麻醉期间WLI与BIS相比可被接受。偏差为-2.99,95%一致性界限为-29.97%至21.56%。OAA/S评分与BIS和WLI的相关系数分别为:r(BIS)=0.884,r(WLI)=0.757(P=0.000)。
WLI指数可用于监测全身麻醉深度。