摘要
目的 研究应用脑电双频谱指数 (BIS)监测反馈调控静吸复合麻醉的可行性。方法 将50例择期手术病人随机分为对照组 (组Ⅰ )和BIS反馈组 (组Ⅱ ) ,每组25例。组I术中麻醉深度以MAP、HR和对手术刺激的反应为依据调节麻醉深度。组II以BIS值40～50作为反馈值调节麻醉深度 ,BIS>50时提高吸入异氟醚浓度 ,<40时降低吸入异氟醚浓度。记录两组病人入室后、意识消失、气管插管前、气管插管后、切皮、术中、停异氟醚后10min、吞咽反射和睁眼时BIS值、肺泡最低有效浓度(MAC)、MAP和HR等的变化 ,记录意识恢复的时间 ,随访有否术中知晓。 结果 麻醉诱导后两组病人的BIS值较基础值明显为低 (P<0.01) ,术中两组病人的BIS值差别不显著 (P>0.05) ;停异氟醚后10min,组ⅡBIS值明显高于组Ⅰ (P<0.01) ;术中吸2%异氟醚时间组Ⅱ明显短于组Ⅰ(P<0.01) ;术毕唤醒时间组Ⅱ早于组Ⅰ (P<0.05) ;术后随访50例病人均无术中知晓。结论 应用BIS值反馈调控静吸复合全身麻醉 ,可更加合理地评估麻醉深度 ,防止术中知晓 ,减少麻醉用药量 ,加快病人苏醒。
Objective To study the feasibility of application of bispectral index(BIS)feedback in control of intravenous combined with inhalation general anesthesia.Methods Fifty patients were randomized into control group(group I)and BIS feedback group(group II),with25in each group.In group I,anesthesia depth adjusting was based on MAP,HR and the reaction of operation stimulation.In group II with BIS40～50as feedback count,as BIS>50the concentration of inhalating Isoflurane should be raised and as BIS<40Isoflurane concentration reduced.Record changing of BIS,minimal alveolar concentration(MAC),MAP and HR,unconˉsciousness,before placement of endobronchial tube,after placement of endobronchial tube,cutting skin,during operation,stopping inhalating Isoflurane10minutes later,swallowreflection,and open eyes with two groups of patients;also record consciousness recovery time,check patients have no awareness during operation.Results After induction of anesthesia.BIS count of two groups was significant different(P<0.01);during operation BIS count of patients had no significant difference(P<0.05).10minutes after stopping inhalating Isoflurane,BIS count of group II was higher than that of group I(P<0.01).During operation the time of inhalating Isoflurane of2%in group II was significantly shorter than that of group I(P<0.01);the time of patients awaken in group II was earlier than that in group I at the end of operation(P<0.05).Conclusion It may be more reasonably with intravenous combined with inhalation general anesthesia to apply BIS feedback controls of anesthesia depth to prevent from awareness during operation,to decrease the doses of anesthetics and to accelerate consciousness recovery.
出处
《浙江医学》
CAS
2003年第9期527-528,568,共3页
Zhejiang Medical Journal
