上海医学
上海醫學
상해의학
SHANGHAI MEDICAL JOURNAL
2010年
2期
128-131
,共4页
镇静深度监测%脑电小波分析%熵指数%脑电双频指数%丙泊酚
鎮靜深度鑑測%腦電小波分析%熵指數%腦電雙頻指數%丙泊酚
진정심도감측%뇌전소파분석%적지수%뇌전쌍빈지수%병박분
Depth of sedation%Wave-let analysis%Spectral entropy%Bispectral index%Propofol
目的 观察小波指数(WAV)、脑电双频指数(BIS)、频谱熵指数[反应熵(RE)和状态熵(SE)]与丙泊酚静脉麻醉时镇静深度的关系.方法 随机选择美国麻醉医师学会(ASA)分级Ⅰ～Ⅱ级拟在全身麻醉下行择期手术的患者22例,年龄18～65岁.丙泊酚靶控输注(TCI)起始血浆浓度为1μg/mL,以后每4 min增加1μg/mL,直至觉醒/镇静评分(OAA/S评分)为1分时停止给药.记录每一级OAA/S评分和复苏期间患者呼之睁眼及能握手时的心率(HR)、血压(BP)、WAV、BIS、RE和SE值.结果 WAV(r=0.945)、BIS(r=0.940)、RE(r=0.911)和SE(r=0.896)与OAA/S评分均呈正相关(P值均<0.05),WAV与OAA/s评分的r值与BIS、RE相似,但显著高于SE(P<0.05).WAV对患者意识消失有较好的预测性,其预知概率(Pk)值与BIS、RE和SE相近,分别为0.73、0.76、0.71、0.79.停止输注丙泊酚后,WAV降至最低值的时间较RE迟(14.3±8.4)s,但较BIS早(8.7±8.6)S.WAV对患者意识恢复亦有较好的预测性,其Pk值(0.77)与RE(0.76)和SE(0.74)相近,优于BIS(0.69).患者意识恢复时RE较BIS和WAV高,但均未恢复至基础值.结论 WAV、BIS和频谱熵指数均与丙泊酚麻醉中镇静深度呈正相关.WAV对单纯丙泊酚麻醉时意识消失和恢复均有良好的预测性,且可能优于BIS.
目的 觀察小波指數(WAV)、腦電雙頻指數(BIS)、頻譜熵指數[反應熵(RE)和狀態熵(SE)]與丙泊酚靜脈痳醉時鎮靜深度的關繫.方法 隨機選擇美國痳醉醫師學會(ASA)分級Ⅰ～Ⅱ級擬在全身痳醉下行擇期手術的患者22例,年齡18～65歲.丙泊酚靶控輸註(TCI)起始血漿濃度為1μg/mL,以後每4 min增加1μg/mL,直至覺醒/鎮靜評分(OAA/S評分)為1分時停止給藥.記錄每一級OAA/S評分和複囌期間患者呼之睜眼及能握手時的心率(HR)、血壓(BP)、WAV、BIS、RE和SE值.結果 WAV(r=0.945)、BIS(r=0.940)、RE(r=0.911)和SE(r=0.896)與OAA/S評分均呈正相關(P值均<0.05),WAV與OAA/s評分的r值與BIS、RE相似,但顯著高于SE(P<0.05).WAV對患者意識消失有較好的預測性,其預知概率(Pk)值與BIS、RE和SE相近,分彆為0.73、0.76、0.71、0.79.停止輸註丙泊酚後,WAV降至最低值的時間較RE遲(14.3±8.4)s,但較BIS早(8.7±8.6)S.WAV對患者意識恢複亦有較好的預測性,其Pk值(0.77)與RE(0.76)和SE(0.74)相近,優于BIS(0.69).患者意識恢複時RE較BIS和WAV高,但均未恢複至基礎值.結論 WAV、BIS和頻譜熵指數均與丙泊酚痳醉中鎮靜深度呈正相關.WAV對單純丙泊酚痳醉時意識消失和恢複均有良好的預測性,且可能優于BIS.
목적 관찰소파지수(WAV)、뇌전쌍빈지수(BIS)、빈보적지수[반응적(RE)화상태적(SE)]여병박분정맥마취시진정심도적관계.방법 수궤선택미국마취의사학회(ASA)분급Ⅰ～Ⅱ급의재전신마취하행택기수술적환자22례,년령18～65세.병박분파공수주(TCI)기시혈장농도위1μg/mL,이후매4 min증가1μg/mL,직지각성/진정평분(OAA/S평분)위1분시정지급약.기록매일급OAA/S평분화복소기간환자호지정안급능악수시적심솔(HR)、혈압(BP)、WAV、BIS、RE화SE치.결과 WAV(r=0.945)、BIS(r=0.940)、RE(r=0.911)화SE(r=0.896)여OAA/S평분균정정상관(P치균<0.05),WAV여OAA/s평분적r치여BIS、RE상사,단현저고우SE(P<0.05).WAV대환자의식소실유교호적예측성,기예지개솔(Pk)치여BIS、RE화SE상근,분별위0.73、0.76、0.71、0.79.정지수주병박분후,WAV강지최저치적시간교RE지(14.3±8.4)s,단교BIS조(8.7±8.6)S.WAV대환자의식회복역유교호적예측성,기Pk치(0.77)여RE(0.76)화SE(0.74)상근,우우BIS(0.69).환자의식회복시RE교BIS화WAV고,단균미회복지기출치.결론 WAV、BIS화빈보적지수균여병박분마취중진정심도정정상관.WAV대단순병박분마취시의식소실화회복균유량호적예측성,차가능우우BIS.
Objective To study the correlation of wavelet analysis (WAV), bispectral analysis (BIS), spectral entropy (responsive entropy [RE]and state entropy [SE]) with depth of sedation during propofol anaesthesia. Methods Twenty-two 18-65 years old patients (American Society Anesthesiologists [ASA]class Ⅰ～Ⅱ) undergoing elective operation under general anesthesia were included in the present study. The target controlled infusion (TCI) of propofol was initiated at target plasma concertration of 1 μg/mL, increased by 1 μg/mL steps every 4 min, and stopped until observers assessment of alertness/sedation (OAA/S) scale 1 scale. The heart rate (HR), blood pressure (BP), WAV, BIS, RE, and SE were recorded at each OAA/S scale during induction and during eye-opened, hands-held. Results WAV was well correlated with OAA/S scale, with its r value similar to those of BIS and RE, but highter than that of SE. WAV could well predict the unconsciousness of patients. The prediction probability (Pk) of WAV, BIS, RE and SE were 0.73, 0.76, 0.71, and 0.79, respectively. After propfol was stopped, changes of WAV were (14.3±8.4) s later than RE, but (8.7±8.6) s earlier than BIS. WAV could also well predict the consciousness of patients during recovery. The Pk value of WAV vs. eye-opening and obeying the command was similar to RE and SE, but highter than BIS. During recovery of consciousness, RE was higher than WAV and SE, but none of them returned to the baseline. Conclusion WAV, BIS and Entropy are well correlated with depth of sedation and consciousness during propofol anaesthesia. WAV can well predict the unconsciousness and the recovery from consciousness during single propofol anaesthesia, and it might be a better predictor than BIS.
