脑电双频指数在男性无痛膀胱镜检查中的应用

Application of bispectral index monitoring in male patients in checking of painless cystoscopy

目的 探讨男性患者无痛膀胱镜检查中脑电双频指数(BIS)监测在指导麻醉深度、减少麻醉并发症方面的意义.方法 将80例ASA分级Ⅰ～Ⅱ级门诊行膀胱镜检查的男性患者随机分为BIS组(Ⅰ组)和对照组(Ⅱ组),每组40例.静脉给予芬太尼1 μg/kg、丙泊酚0.5 mg/kg负荷量后,丙泊酚的维持量Ⅰ组根据BIS监测调节使BIS维持在40~60之间,Ⅱ组根据临床体征调节.比较膀胱镜检查时间、丙泊酚用量、术中反应及苏醒时间等.结果 两组患者麻醉前平均动脉压(MAP)、心率、脉搏血氧饱和度、BIS比较差异均无统计学意义(P＞0.05).MAP在麻醉诱导入睡后两组均有下降,但Ⅰ组降幅小于Ⅱ组(P＜0.05).Ⅰ组丙泊酚用量明显少于Ⅱ组,苏醒时间I组明显短于Ⅱ组(P＜0.05),术中不良反应发生率I组明显少于Ⅱ组(P＜0.05).结论 男性患者无痛膀胱镜检查中BIS监测可较好的控制麻醉深度,减少麻醉并发症的发生.

Objective To observe the application of bispectral (BIS) index monitoring in male patients in checking of painless cystoscopy under propofol intravenous anesthesia and to investigate the feasibility of BIS on guilding the anesthetic depth. Methods Eighty ASA Ⅰ-Ⅱ male patients undergoing selective cystoscopy check with propofol-fentanyl anesthesia were randomly divided into two groups: BIS group (groupⅠ,n=40) and control group (group Ⅱ,n=40). Anesthesia was induced with fentanyl 1 μg/kg and propofol 0.5 mg/kg. In groupⅠ, propofol infusion was adjusted to achieve a target BIS of 40-60. In group Ⅱ, propofol dose was adjusted according to the standard clinical signs. The amount of propofol, intraoperative responses and recovery parameters were recorded. Results MAP, HR, SpO2 and BIS of all the patients were not signifisantly different before anesthesia. The amount of propofol used and time of recovery were significantly less in group Ⅰ than that in group Ⅱ(P＜0.05). A MAP decrease of two groups was found during anesthesia, however, the decrease level and the adverse effects were significantly less in group Ⅰ than that in group Ⅱ(P＜0.05). Conclusions Monitoring the depth of anesthesia with BIS during propofol intravenous anesthesia in male patients undergoing cystoscopy check can maintain adequate and smooth anesthesia with less anesthetic and complications of anesthesia.