Guo Z G, Jia X P, Wang X Y, Li P, Su X J, Hao J H
Department of Anesthesiology, First Affiliated Hospital of General Hospital of PLA, Beijing, China.
Department of Anesthesiology, First Affiliated Hospital of General Hospital of PLA, Beijing, China
Genet Mol Res. 2015 Jul 13;14(3):7597-604. doi: 10.4238/2015.July.13.3.
This study evaluated the feasibility and effectiveness of using the bispectral index (BIS) to monitor anesthetic depth in patients with severe burns receiving intravenous target-controlled infusion (TCI) of remifentanil and propofol. We randomly assigned 80 patients undergoing elective escharectomy (<1 week) to BIS (A) and control (B) groups. All patients received remifentanil and propofol as intravenous TCI anesthesia. Clinical data were recorded at different time points. The time from drug withdrawal to eye opening upon the patient hearing his/her name called and upon reaching an Aldrete score of 9 points was also recorded. During anesthesia maintenance, the target concentrations of remifentanil and propofol in group A were significantly lower than that in group B (2.12 ± 0.35 vs 2.50 ± 0.21 ng/mL and 2.54 ± 0.22 vs 2.86 ± 0.31 μg/mL, respectively; P < 0.01). The time from drug withdrawal to eye opening upon the patient hearing his/her name called and reaching an Aldrete score of 9 points in group A was considerably shorter than that in group B (7.90 ± 0.58 vs 8.35 ± 0.66 min and 9.15 ± 0.69 vs 11.13 ± 0.96 min, respectively; P < 0.01). In both groups, mean arterial pressure and heart rate values at each time point after loss of consciousness were significantly lower than the baseline values (P < 0.05), with the exception of 2 min after intubation. The use of BIS to monitor anesthetic depth in patients with severe burns receiving TCI of remifentanil and propofol during the perioperative period reduces propofol consumption and shortens the consciousness recovery time in patients.
本研究评估了在接受瑞芬太尼和丙泊酚静脉靶控输注（TCI）的重度烧伤患者中，使用脑电双频指数（BIS）监测麻醉深度的可行性和有效性。我们将80例行择期切痂术（<1周）的患者随机分为BIS组（A组）和对照组（B组）。所有患者均接受瑞芬太尼和丙泊酚静脉TCI麻醉。记录不同时间点的临床数据。还记录了患者听到叫其名字以及Aldrete评分达到9分时从停药到睁眼的时间。在麻醉维持期间，A组瑞芬太尼和丙泊酚的靶浓度显著低于B组（分别为2.12±0.35 vs 2.50±0.21 ng/mL和2.54±0.22 vs 2.86±0.31 μg/mL；P<0.01）。A组患者听到叫其名字以及Aldrete评分达到9分时从停药到睁眼的时间明显短于B组（分别为7.90±0.58 vs 8.35±0.66分钟和9.15±0.69 vs 11.13±0.96分钟；P<0.01）。两组中，意识消失后各时间点的平均动脉压和心率值均显著低于基线值（P<0.05），但插管后2分钟除外。在围手术期，对接受瑞芬太尼和丙泊酚TCI的重度烧伤患者使用BIS监测麻醉深度可减少丙泊酚用量并缩短患者意识恢复时间。
