脑电非线性分析用于静脉麻醉下异丙酚脑区作用的研究

The effect of propofol different areas of brain cortex under intravenous propofol anesthesia as studied by EEG non-linear analysis

目的 研究围术期静脉复合麻醉下异丙酚在脑区的作用。方法 20例患者随机均分为异丙酚8mg/(kg·h)组与 10mg/(kg·h)组,记录围术期近似熵与关联维数,常规监测BP、HR、SpO2。结果 与入室后相比,两组患者麻醉后均表现为额叶、顶 叶、颞叶脑区的脑电抑制程度较高。两组患者入室后与麻醉下相比较,关联维数、近似熵明显降低,差异有统计学意义(P<0.05),术 中与复苏、觉醒相比较,数值有明显的差异,差异有统计学意义(P<0.05)。患者在复苏与觉醒后各个脑区的脑电变化表现为额叶、顶 叶、颞叶的脑电活动度较高。结论 静脉异丙酚麻醉下,各个脑区的抑制程度是不同的,以额叶、顶叶、颞叶的抑制程度较高;额叶、顶 叶、颞叶区在复苏觉醒时兴奋程度较高。

Objective To study effect of propofol on different areas of brain cortex under total intravenous propofol and fentanyl anesthesia. Methods 20 patients were randomly divided into propofol 8mg/(kg·h) group (n=10) and 10mg/(kg·h) group (n=10). The anesthesia was maintained by total intravenous propofol and fentanyl anesthesia. The EEG non-linear parameters, i.e. approximate entropy (ApEn)and correlation dimension (D 2), were recorded during perioperative periods. BP, HR, SpO 2 were monitored routinely. Results Compared with that at entry of OR, the EEG activities of frontal, parietal, and temporal cortices after anesthesia were more inhibited than that of other areas in both groups. Also EEG non-linear parameters were lower significantly after anesthesia in both groups compared with those at entry of OR (P<0.05). On the other hand , these parameters were elevated significantly on awakening of the patients (P<0.05). After resuscitation, the EEG activities of frontal, parietal and temporal cortices were still stronger than other areas of the cortex. Conclusion Under total intravenous propofol and fentanyl anesthesia, the inhibiting effect on different area of the cortex by propofol as shown by EEG are different in degree, being stronger in frontal, parietal and temporal cortices. The activities are stronger in the frontal, parietal and temporal cortices after awakening and resuscitation.