内镜超声检查期间双谱指数引导下的丙泊酚镇静
Bispectral index-guided propofol sedation during endoscopic ultrasonography.
作者信息
Okamoto Ayana, Kamata Ken, Miyata Takeshi, Yoshikawa Tomoe, Ishikawa Rei, Yamazaki Tomohiro, Nakai Atsushi, Omoto Shunsuke, Minaga Kosuke, Yamao Kentaro, Takenaka Mamoru, Chiba Yasutaka, Sakurai Toshiharu, Nishida Naoshi, Kitano Masayuki, Kudo Masatoshi
机构信息
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osakasayama, Japan.
Clinical Research Center, Kindai University Hospital, Osakasayama, Japan.
出版信息
Clin Endosc. 2022 Jul;55(4):558-563. doi: 10.5946/ce.2022.001. Epub 2022 Jul 12.
BACKGROUND/AIMS: Bispectral index (BIS) monitors process and display electroencephalographic data are used to assess the depth of anesthesia. This study retrospectively evaluated the usefulness of BIS monitoring during endoscopic ultrasonography (EUS).
METHODS
This study included 725 consecutive patients who underwent EUS under sedation with propofol. BIS monitoring was used in 364 patients and was not used in 361. The following parameters were evaluated: (1) median dose of propofol; (2) respiratory and circulatory depression; (3) occurrence of body movements; (4) awakening score >8 at the time; and (5) awakening score 2 hours after leaving the endoscopy room.
RESULTS
The BIS group received a significantly lower median dose of propofol than the non-BIS group (159.2 mg vs. 167.5 mg; p=0.015) in all age groups. For patients aged ≥75 years, the reduction in heart rate was significantly lower in the BIS group than in the non-BIS group (1.2% vs. 9.1%; p=0.023). Moreover, the occurrence of body movements was markedly lower in the BIS group than in the non-BIS group (8.5% vs. 39.4%; p<0.001).
CONCLUSION
During EUS examination, BIS monitoring is useful for maintaining a constant depth of anesthesia, especially in patients 75 years of age or older.
背景/目的：脑电双频指数（BIS）监测仪处理并显示脑电图数据，用于评估麻醉深度。本研究回顾性评估了内镜超声检查（EUS）期间BIS监测的有效性。
方法
本研究纳入了725例连续接受丙泊酚镇静下EUS检查的患者。364例患者使用了BIS监测，361例未使用。评估了以下参数：（1）丙泊酚的中位剂量；（2）呼吸和循环抑制；（3）身体运动的发生情况；（4）当时觉醒评分>8；（5）离开内镜室2小时后的觉醒评分。
结果
在所有年龄组中，BIS组接受的丙泊酚中位剂量显著低于非BIS组（159.2 mg对167.5 mg；p = 0.015）。对于年龄≥75岁的患者，BIS组心率下降幅度显著低于非BIS组（1.2%对9.1%；p = 0.023）。此外，BIS组身体运动的发生率明显低于非BIS组（8.5%对39.4%；p<0.001）。
结论
在EUS检查期间，BIS监测有助于维持恒定的麻醉深度，尤其是在75岁及以上的患者中。
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