脑电双频指数与听觉诱发电位指数监测诱导期麻醉深度的比较

Comparison of BIS and AEP index for monitoring depth of anesthesia during induction

目的 比较丙泊酚或复合芬太尼行麻醉诱导时 ,脑电双频指数 (BIS)与听觉诱发电位指数 (AAI)监测意识变化的敏感性。方法 4 0例病人随机均分为丙泊酚组 (P组 )组和丙泊酚加芬太尼组 (PF组 )。麻醉诱导均用丙泊酚 30mg·kg 1·h 1的速率泵注 ,PF组于丙泊酚静注 2min前给予芬太尼 2 μg/kg。记录意识消失时BIS和AAI值、意识消失时间和丙泊酚用量 ,并测定血浆丙泊酚浓度。结果 PF组病人意识消失时间、丙泊酚用量和血浆丙泊酚浓度均较P组低 (P <0 0 1)。意识消失时PF组BIS值高于P组 (P <0 0 1) ;而两组AAI却无显著性差异 (P >0 0 5 )。结论 丙泊酚麻醉诱导时 ,无论是否合用芬太尼 ,AAI均可较好地反映意识的转换 ;而BIS则会因药物组合的不同而出现变化。结果提示 。

Objective To compare the performance of bispectral index (BIS) and the auditory evoked response index (AAI) in detecting transitions in consciousness during anesthesia induction with propofol alone or propofol plus fentanyl.Methods Anesthesia was induced with either an intravenous infusion of 30 mg·kg -1·h -1of propofol plus 2 μg/kg of fentanyl (group PF,n=20) or propofol alone(group P,n=20). BIS,AAI and the doses of propofol administered were recorded at the endpoint of unresponsiveness to verbal commands.Plasma propofol concentration was also measured. Results The propofol dose and its plasma concentration required for getting loss of consciousness were significantly lower in group PF than those in group P(P<0.01). The mean BIS value at the loss of consciousness was significantly higher in group PF than that in group P (P<0.01). However,no difference in AAI was found between the two groups at the loss of consciousness (P>0.05). Conclusion The AAI can measure the transition from consciousness to unconsciousness at similar value levels,regardless of whether or not fentanyl pretreatment was added,whereas the BIS values in patients in group PF were higher at this endpoint than those in group P,suggesting that compared with BIS,the AAI may be a better indicator of the state of consciousness during propofol/fentanyl anesthesia,and that AAI can detect the transition of the state of consciousness independent of the anesthesia regimen.