BIS和AEPI监测镇静深度的评价

Evaluation of sedation depth monitoring with bispectral and auditory evoked potential index

目的比较脑电双频指数(BIS)和听觉诱发电位指数(AEPI)在丙酚靶控镇静深度的临床价值。方法45例腰-硬联合麻醉术中需丙泊酚镇静病人,ASAⅠ级,腰麻平面确定后开始丙泊酚靶控输注镇静。结果(1)丙泊酚镇静期BIS、AEPI逐渐降低,苏醒期逐渐升高(P<0.01),而AEPI则在意识转换过程中变化更敏感(P<0.01)。(2)在丙泊酚镇静期和苏醒期BIS、AEPI与丙泊酚EC密切相关。(3)在丙泊酚镇静期,联合监测当BIS≤63和AEPI≤30时敏感度即可达100%。结论BIS和AEPI是监测麻醉镇静深度的良好指标,BIS和AEPI联合监测提高了诊断的敏感度。

Objective To compare the value of sedation depth monitoring with bispectral index （B/S） and auditory evoked potential index（AEPl）. Methods Fouty-five patients under combined spinal-epidural anesthesia were sedated with propofol target controlled infusion（TCI）. During sedation and emergence from anesthesia, the BIS, AEPI and prOpofol effective concentrations （EC） were recorded when EC was increased or decreased by 0.1μg/ml each time. Results （1）During sedation and emergence from anesthesia, the values of BIS and AEPI gradually decreased and increased respectively,in which the change of AEPI was more sensitive than that of BIS（P〈0.01）. （2）During sedation,the values of BIS and AEPI were closely correlated with propofol EC. （3）During sedation with propofol TCI,the sensitivity of BIS≤63 and AEPI≤30 was 100%. Conclusion BIS and AEPI are good predictors of the level of sedation during propofol infusion, especially combined use of BIS and AEPI.