Department of Anesthesiology, Kansai Medical University Medical Center, 10-15, Fumizono-Cho, Moriguchi, Osaka, 570-0074, Japan.
Department of Anesthesia, Kansai Medical University Hospital, 2-5-1, Shin-Machi, Hirakata, Osaka, 573-1191, Japan.
J Anesth. 2024 Dec;38(6):855-864. doi: 10.1007/s00540-024-03406-5. Epub 2024 Sep 9.
Studies show that the two peak heights of electroencephalographic bicoherence (pBIC-high, pBIC-low) decrease after incision and are restored by fentanyl administration. We investigated whether pBICs are good indicators for adequacy of analgesia during surgery.
After local ethical committee approval, we enrolled 50 patients (27-65 years, ASA-PS I or II) who were scheduled elective surgery. Besides standard anesthesia monitors, to assess pBICs, we used a BIS monitor and freeware Bispectrum Analyzer for A2000. Fentanyl 5 µg/kg was completely administered before incision, and anesthesia was maintained with sevoflurane. After skin incision, when the peak of pBIC-high or pBIC-low decreased by 10% in absolute value (named LT10-high and LT10-low groups in order) or when either peak decreased to below 20% (BL20-high and BL20-low groups), an additional 1 g/kg of fentanyl was administered to examine its effect on the peak that showed a decrease.
The mean values and standard deviation for pBIC-high 5 min before fentanyl administration, at the time of fentanyl administration, and 5 min after fentanyl administration for LT10-high group were 39.8% (10.9%), 26.9% (10.5%), and 35.7% (12.5%). And those for pBIC-low for LT10-low group were 39.5% (6.0%), 26.8% (6.4%) and 35.0% (7.0%). Those for pBIC-high for BL20-high group were 26.3% (5.6%), 16.5% (2.6%), and 25.7% (7.0%). And those for pBIC-low for BL20-low group were 26.7% (4.8%), 17.4% (1.8%) and 26.9% (5.7%), respectively. Meanwhile, at these trigger points, hemodynamic parameters didn't show significant changes.
Superior to standard anesthesia monitoring, pBICs are better indicators of analgesia during surgery.
Clinical trial Number and registry URL: UMIN ID: UMIN000042843 https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno = R000048907.
研究表明，脑电双频指数（bicoherence，BIC）的两个峰值高度（pBIC-high，pBIC-low）在切口后降低，并可通过芬太尼给药恢复。我们研究了 pBIC 是否是手术期间镇痛充分的良好指标。
在获得当地伦理委员会批准后，我们纳入了 50 名择期手术患者（年龄 27-65 岁，ASA 分级 PS I 或 II）。除了标准的麻醉监测外，我们还使用 BIS 监测仪和免费的 Bispectrum Analyzer for A2000 评估 pBIC。在切开前给予芬太尼 5μg/kg 静脉注射，然后以七氟醚维持麻醉。在皮肤切开后，当 pBIC-high 或 pBIC-low 的峰值绝对值降低 10%（分别命名为 LT10-high 和 LT10-low 组）或两个峰值均降低至 20%以下（BL20-high 和 BL20-low 组）时，给予 1μg/kg 静脉注射芬太尼，以观察其对出现下降的峰值的影响。
LT10-high 组在给予芬太尼前 5 分钟、给予芬太尼时和给予芬太尼后 5 分钟的 pBIC-high 平均值和标准差分别为 39.8%（10.9%）、26.9%（10.5%）和 35.7%（12.5%）。LT10-low 组的 pBIC-low 分别为 39.5%（6.0%）、26.8%（6.4%）和 35.0%（7.0%）。BL20-high 组的 pBIC-high 分别为 26.3%（5.6%）、16.5%（2.6%）和 25.7%（7.0%）。BL20-low 组的 pBIC-low 分别为 26.7%（4.8%）、17.4%（1.8%）和 26.9%（5.7%）。同时，在这些触发点，血液动力学参数没有显示出显著变化。
与标准麻醉监测相比，pBIC 是手术期间镇痛的更好指标。
临床试验编号和注册网址：UMIN ID：UMIN000042843 https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno = R000048907.
