Li Zhitao, Cai Jiachun, Li Jiexiong, Xu Xianghui, Zheng Limin
Department of Anaesthesiology, Peking University Shenzhen Hospital, Shenzhen, China.
Shenzhen Eye Hospital, Shenzhen, China.
J Int Med Res. 2021 Apr;49(4):3000605211001705. doi: 10.1177/03000605211001705.
To compare the accuracy, correlation and agreement between the bispectral index (BIS) and BISpro during propofol anaesthesia.
The BIS, BISpro, heart rate, target-concentration of propofol and Observer's Assessment of Alertness and Sedation (OAA/S) score were recorded every 30 s in female patients scheduled for hysteroscopic surgery. Propofol anaesthesia was induced by an initial target-controlled concentration (1.0 μg/ml) followed by a stepwise increase (0.5 μg/ml) until the patient was unresponsive. Spearman's correlation coefficient and prediction probability were calculated for the association between sedation levels and the above parameters. The ability of investigated parameters to distinguish between OAA/S scores was analysed. Bland-Altman analysis was used to compare the agreement between BIS and BISpro. The BIS and BISpro cut-off values for lost response were also determined.
Out of 30 patients in total, a high correlation was found between BIS and BISpro, and both correlated well with OAA/S score. Only BIS was able to distinguish all investigated OAA/S states accurately, but the ability to predict OAA/S score 5 to loss of response was comparable between BIS and BISpro. The calculated cut-off values were 68 for BIS and 70 for BISpro.
BISpro and BIS are reliable monitors of general anaesthesia during sedation.: Chinese Clinical Trial Registry (URL: www.chictr.org.cn): ChiCTR1900024037 (retrospectively registered).
比较双频谱指数(BIS)与BISpro在丙泊酚麻醉期间的准确性、相关性和一致性。
对计划进行宫腔镜手术的女性患者,每隔30秒记录一次BIS、BISpro、心率、丙泊酚目标浓度以及观察者警觉与镇静评分(OAA/S)。丙泊酚麻醉诱导采用初始目标控制浓度(1.0μg/ml),随后逐步增加(0.5μg/ml),直至患者无反应。计算镇静水平与上述参数之间的Spearman相关系数和预测概率。分析所研究参数区分OAA/S评分的能力。采用Bland-Altman分析比较BIS与BISpro之间的一致性。还确定了BIS和BISpro失去反应的临界值。
总共30例患者中,BIS与BISpro之间存在高度相关性,且二者均与OAA/S评分相关性良好。只有BIS能够准确区分所有研究的OAA/S状态,但在预测OAA/S评分5至失去反应方面,BIS和BISpro的能力相当。计算得出的临界值为BIS 68,BISpro 70。
BISpro和BIS是镇静期间全身麻醉的可靠监测指标。中国临床试验注册中心(网址:www.chictr.org.cn):ChiCTR1900024037(回顾性注册)。