中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2008年
11期
1013-1015
,共3页
脑电描记术%清醒镇静%麻醉,全身%监测,生理学
腦電描記術%清醒鎮靜%痳醉,全身%鑑測,生理學
뇌전묘기술%청성진정%마취,전신%감측,생이학
Electroencephalography%Conscious sedation%Anesthesia,general%Monitoring,physiologic
目的 评价反应熵和状态熵监测全麻患者镇静水平的准确性.方法 择期行腹部手术患者20例,ASAⅠ或Ⅱ级,入室后监测反应熵(RE)、状态熵(SE)及脑电双频谱指数(BIS),静脉注射异丙酚、维库溴铵和芬太尼麻醉诱导,气管插管后机械通气,吸入七氟烷、间断静脉注射维库溴铵和芬太尼维持麻醉.分别于入室时、意识消失前10min、意识消失即刻、气管插管时、手术1 h、意识恢复前10 min、意识恢复即刻、拔管后10 min时记录RE、SE和BIS.结果 RE、SE和BIS在意识改变前后差异均有统计学意义(P＜0.05),RE、SE和BIS判断意识消失的临界值分别为76、73和68,灵敏度分别为94%、95%和92%,特异度分别为92%、94%和9l%,临界值判断意识消失的准确度分别为93%、95%、94%;判断意识恢复的临界值分别为82、75和70,灵敏度分别为95%、95%和91%,特异度分别为93%、96%和93%,临界值判断意识恢复的准确度分别为98%、96%和97%.结论 熵指数能够准确地监测全麻患者镇静水平.
目的 評價反應熵和狀態熵鑑測全痳患者鎮靜水平的準確性.方法 擇期行腹部手術患者20例,ASAⅠ或Ⅱ級,入室後鑑測反應熵(RE)、狀態熵(SE)及腦電雙頻譜指數(BIS),靜脈註射異丙酚、維庫溴銨和芬太尼痳醉誘導,氣管插管後機械通氣,吸入七氟烷、間斷靜脈註射維庫溴銨和芬太尼維持痳醉.分彆于入室時、意識消失前10min、意識消失即刻、氣管插管時、手術1 h、意識恢複前10 min、意識恢複即刻、拔管後10 min時記錄RE、SE和BIS.結果 RE、SE和BIS在意識改變前後差異均有統計學意義(P＜0.05),RE、SE和BIS判斷意識消失的臨界值分彆為76、73和68,靈敏度分彆為94%、95%和92%,特異度分彆為92%、94%和9l%,臨界值判斷意識消失的準確度分彆為93%、95%、94%;判斷意識恢複的臨界值分彆為82、75和70,靈敏度分彆為95%、95%和91%,特異度分彆為93%、96%和93%,臨界值判斷意識恢複的準確度分彆為98%、96%和97%.結論 熵指數能夠準確地鑑測全痳患者鎮靜水平.
목적 평개반응적화상태적감측전마환자진정수평적준학성.방법 택기행복부수술환자20례,ASAⅠ혹Ⅱ급,입실후감측반응적(RE)、상태적(SE)급뇌전쌍빈보지수(BIS),정맥주사이병분、유고추안화분태니마취유도,기관삽관후궤계통기,흡입칠불완、간단정맥주사유고추안화분태니유지마취.분별우입실시、의식소실전10min、의식소실즉각、기관삽관시、수술1 h、의식회복전10 min、의식회복즉각、발관후10 min시기록RE、SE화BIS.결과 RE、SE화BIS재의식개변전후차이균유통계학의의(P＜0.05),RE、SE화BIS판단의식소실적림계치분별위76、73화68,령민도분별위94%、95%화92%,특이도분별위92%、94%화9l%,림계치판단의식소실적준학도분별위93%、95%、94%;판단의식회복적림계치분별위82、75화70,령민도분별위95%、95%화91%,특이도분별위93%、96%화93%,림계치판단의식회복적준학도분별위98%、96%화97%.결론 적지수능구준학지감측전마환자진정수평.
Objective To evaluate the accuracy of spectral entropy including response entropy(RE)and state entropy(SE)as a new electroencephalographic measure of depth of sedation during general anesthesia.Methods Twenty ASA Ⅰ or Ⅱ patients aged 20-55 yr undergoing elective abdominal surgery were studied.Anesthesia Was induced with intravenous propofol,fentanyl and vecuronium.After tracheal intubation anesthesia was maintained with sevoflurane inhalation and intermittent iv boluses of fentanyl and vecuronium.BP,HR,SpO2,spectral entropy(Datex-Ohmeda)and BIS(Aspect Medical)were monitored during anesthesia.Loss of eyelash reflex and unresponsiveness to verbal stimulus and mild prodding and shaking were considered to be signs of loss of consciousness(LOC).The time of regaining consciousness Was defined as the time when patients started responding to verbal commands.RE,SE and BIS were recorded before anesthesia(baseline),10 min before LOC,immediately after LOC,immediately after tracbeal intubation,1 h after skin incision,10 min before regaining consciousness immediately after consciousness was regained and 10 min after extubation.Results There were sisnificant changes in RE,SE and BIS during the transition from consciousness to LOC.The RE,SE and BIS values for LOC were 76,73 and 68 with sensitivity of 94%,95%and 92%and specificity of 92%,94%and 91%respectively.The accuracy of RE.SE and BIS in predicting LOC was 93%,95%and 94%respectively.The RE,SE and BIS values for regaining consciousness were 82,75 and 70 with sensitivity of 95%,95%and 91%and specificity of 93%,96%and 93%respectively.The accuracy in predicting regaining of consciousness was 98%,96%and 97%respectively.Conclusion Entropy index Can accurately monitor level of sedation during general anesthesia.
