中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
6期
6-8
,共3页
靶控输注%脑电双频指数%熵指数
靶控輸註%腦電雙頻指數%熵指數
파공수주%뇌전쌍빈지수%적지수
Target-controlled infusion%Bispectral index%Entropy index
目的 比较在靶控输注丙泊酚麻醉诱导的不完全肌松状态下,脑电双频指数(BIS)和熵指数对麻醉深度评价的准确性.方法 选择ASA分级Ⅰ～Ⅱ级的慢性鼻窦炎行鼻窦开放手术患者50例,入手术室后(T0)麻醉诱导静脉靶控输注丙泊酚,设置初始预期血浆浓度为2.1μg/ml,达到预期血浆浓度后(T1)每30 s增加0.3μg/ml,直至睫毛反射消失,待患者意识消失(T2),再增加0.5μg/ml(T3),达到此血浆浓度后30 s给予罗库溴铵0.6 mg/kg(T4),1 min后行气管插管术,并记录T0～T4及气管插管时(T5)、气管插管后1和3 min(T6、T7)、切皮即刻(T8)的平均动脉压(MAP)、心率、BIS、状态熵指数(SE)及反应熵指数(RE).结果 与T0比较,其余各时间点BIS、RE、SE均明显降低(P＜0.05)；MAP、心率均在正常范围内；各时间点RE均较SE明显升高(93±9比87±5,88±12比82±12,73±25比72±21,57±21比56±22,46±16比43±17,39±14比37±12,36±14比34±11,35±11比32±9,39±15比36±12)(P＜ 0.05).麻醉诱导期间BIS与SE、RE在各时间点呈正相关(r=0.887、0.901,P＜0.01).结论 在靶控输注丙泊酚麻醉诱导的不完全肌松状态下,BIS、熵指数皆可较为准确地评价麻醉深度,且两者相关性良好；而其中RE是最灵敏、最迅速评价麻醉深度的指标.
目的 比較在靶控輸註丙泊酚痳醉誘導的不完全肌鬆狀態下,腦電雙頻指數(BIS)和熵指數對痳醉深度評價的準確性.方法 選擇ASA分級Ⅰ～Ⅱ級的慢性鼻竇炎行鼻竇開放手術患者50例,入手術室後(T0)痳醉誘導靜脈靶控輸註丙泊酚,設置初始預期血漿濃度為2.1μg/ml,達到預期血漿濃度後(T1)每30 s增加0.3μg/ml,直至睫毛反射消失,待患者意識消失(T2),再增加0.5μg/ml(T3),達到此血漿濃度後30 s給予囉庫溴銨0.6 mg/kg(T4),1 min後行氣管插管術,併記錄T0～T4及氣管插管時(T5)、氣管插管後1和3 min(T6、T7)、切皮即刻(T8)的平均動脈壓(MAP)、心率、BIS、狀態熵指數(SE)及反應熵指數(RE).結果 與T0比較,其餘各時間點BIS、RE、SE均明顯降低(P＜0.05)；MAP、心率均在正常範圍內；各時間點RE均較SE明顯升高(93±9比87±5,88±12比82±12,73±25比72±21,57±21比56±22,46±16比43±17,39±14比37±12,36±14比34±11,35±11比32±9,39±15比36±12)(P＜ 0.05).痳醉誘導期間BIS與SE、RE在各時間點呈正相關(r=0.887、0.901,P＜0.01).結論 在靶控輸註丙泊酚痳醉誘導的不完全肌鬆狀態下,BIS、熵指數皆可較為準確地評價痳醉深度,且兩者相關性良好；而其中RE是最靈敏、最迅速評價痳醉深度的指標.
목적 비교재파공수주병박분마취유도적불완전기송상태하,뇌전쌍빈지수(BIS)화적지수대마취심도평개적준학성.방법 선택ASA분급Ⅰ～Ⅱ급적만성비두염행비두개방수술환자50례,입수술실후(T0)마취유도정맥파공수주병박분,설치초시예기혈장농도위2.1μg/ml,체도예기혈장농도후(T1)매30 s증가0.3μg/ml,직지첩모반사소실,대환자의식소실(T2),재증가0.5μg/ml(T3),체도차혈장농도후30 s급여라고추안0.6 mg/kg(T4),1 min후행기관삽관술,병기록T0～T4급기관삽관시(T5)、기관삽관후1화3 min(T6、T7)、절피즉각(T8)적평균동맥압(MAP)、심솔、BIS、상태적지수(SE)급반응적지수(RE).결과 여T0비교,기여각시간점BIS、RE、SE균명현강저(P＜0.05)；MAP、심솔균재정상범위내；각시간점RE균교SE명현승고(93±9비87±5,88±12비82±12,73±25비72±21,57±21비56±22,46±16비43±17,39±14비37±12,36±14비34±11,35±11비32±9,39±15비36±12)(P＜ 0.05).마취유도기간BIS여SE、RE재각시간점정정상관(r=0.887、0.901,P＜0.01).결론 재파공수주병박분마취유도적불완전기송상태하,BIS、적지수개가교위준학지평개마취심도,차량자상관성량호；이기중RE시최령민、최신속평개마취심도적지표.
Objective To evaluate the accuracy of bispectral index(BIS)and entropy index in monitoring the depth of anesthesia in patients during target-controlled infusion(TCI)of propofol on induction of anesthesia.Methods Fifty ASA grade Ⅰ-Ⅱ of chronic sinusitis patients who performed the surgery of nasal sinus patency were enrolled in this study.After into operation room(T0),anesthesia was induced with TCI of propofol,and it was added 0.3 μ g/ml after 30 seconds once the plasma drug level was 2.1 μ g/ml(T1)until loss of consciousness(T2),and added 0.5 μg/ml(T3).When tracheal intubation,the patients was injected 0.6 mg/kg rocuronium in their intravenous at the prospective plasma drug level(T4).Each case was monitored with BIS,state entropy index(SE)and response entropy index(RE).The data at following time were recorded:T0-T4,tracheal intubation(T5),1 minute and 3 minutes after tracheal intubation(T6,T7),skin incision(T8).Results The value of BIS,SE and RE were significantly decreased compared with T0 (P ＜0.05).Mean arterial pressure(MAP)and heart rate were in normal range.The value of RE was significantly higher than SE at all the time points(93 ± 9 vs.87 ± 5,88 ± 12 vs.82 ± 12,73 ± 25 vs.72 ± 21,57±21 vs.56±22,46± 16vs.43 ± 17,39± 14 vs.37± 12,36± 14vs.34± 11,35 ± 11 vs.32±9,39±15 vs.36 ± 12)(P ＜ 0.05),but there was no significantly difference between BIS and SE at all the time points(P ＞ 0.05).The value of BIS had significantly positive correlation with SE and RE(r =0.887,0.901 ;P ＜ 0.01).Conclusions During deep hypnosis,BIS,SE and RE all can provide information about the level of consciousness during TCI of propofol on induction of anesthesia.RE is more preponderant as a monitor than BIS and SE.
