摘要
目的 比较听觉诱发电位指数(AAI)、双频谱指数(BIS)、95％边缘频率(SEF)及血液动力学参数监测异丙酚-异氟醚静吸复合全麻恢复期麻醉深度的准确性。方法 选择36例ASAI-II级,听力正常的择期手术病人,实施异丙酚-异氟醚复合麻醉,于麻醉恢复期各时点记录AAI、BIS、SEF及血液动力学参数,并研究AAI与其他指标的相关性。结果 对呼名有反应前后AAI分别为36.1±11.5和52.4±12.3,BIS为71.9±11.5和78.6±11.9,SEF分别为16.7±3.0和18.6±3.2。结论(1)AAI、BIS、SEF均能监测恢复期麻醉深度,以AAI较为敏感。血液动力学指标对恢复期麻醉深度监测意义不大。(2)AAI在呼名有反应时突然升高,能区分有意识和无意识状态,是预测意识恢复的最好指标。
Objective Auditory evoked potential index (AAI) has been proposed for monitoring anesthetic depth. The aim of this study was to compare tins new technique with hispectral index (BIS) and 95% spectral edge frequency (SKF) for assessing anesthetic depth during emergency from propofol-isoflurane anesthesia. The ability of these techniques in distinguishing consciousness from unconsciousness was also evaluated. Methods Thirty six ASA I - II patients ( 15 male, 21 female) undergoing elective surgery under propofol-isoflurane anesthesia were enrolled in the study. Age ranged from 18 to 75 years and body weight from 35 to 80 kg. Patients with psychoneural diseases or hearing disturbances were excluded. The patients were premedicaled with phenobarbitai sodium 0.1g and airopine 0.5mg. Anesthesia was induced with rnidazolam 0 .05-0.1 mg.kg1,fentanyl 5- 10ug.kg1 and vecuronium 0. 1-0.2mg.kg-1 and maintained with propofol infusion (8-16ml. h 1) and isoflurane inhalation (0.5% -1.0%). Intermittent IV boluses of vecuroniuni were given when needed. The patients were transported to recovery room after surgery. AAI, HIS, SKF and hemodynamic parameters were monitored and recorded on entering the recovery room, before extubation, during extubalion, 5, 10, 20 min after exlubation and before release from recovery room. Results AAI, BIS and SEF were 40.9±11.7,73.64±10.8 and 17.5±2.8 respectively on entering recovery room and increased to 72.6 ±11.0, 88.2±7.3 and 22.5±2.6 during exlubation. The increase in AAI was significantly greater. The mean values of AAI before and after responding to light glabellar tap or loud auditory stimulus were 36. 1±11.5 and 52.4±12.3 respectively, the mean values of BIS were 71.9±11.5 and 78 . 6±11.9 and of SKF 16.7±3.0 and 18. 6±3.2 .Only AAI demonstrated a significant difference detween consciousness and unconsciousness. Conclusion AAI, HIS and SKF all increase gradually during emergence from anesthesia. AAI is most sensitive among the three techniques and is most useful in detecting the transition from unconsciousness to consciousness.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2002年第10期593-596,共4页
Chinese Journal of Anesthesiology
