BIS对吗啡镇痛效果的评估

Detection of Analgesia with the Bispectral Index in Patients after Tracheal Intubation

目的研究应用脑电双频指数(BIS)评估气管插管患者镇痛程度的可行性。方法对36名气管插管的清醒患者给予吗啡静脉滴定注射。用药后清醒者归入A组,入睡者为S组。在用药前、用药后20、40、60min记录BIS、Ramsay和视觉模拟疼痛评分(VAS)。结果用药后S组比A组BIS下降更明显;两组患者VAS均明显降低,组间差异不显著。两组VAS的构成情况有显著差异(P=0.04)。两组BIS与RS均呈负相关(分别为A组P<0.01,r=-0.80;S组P<0.01,r=-0.83)。S组BIS与VAS呈正相关(P<0.05,r=0.58),A组BIS与VAS相关性不显著(P>0.05)。结论对气管插管患者,BIS不能准确反映的吗啡静脉滴定注射的镇痛效果。

Objective To evaluate the ability of bispectral index （BIS） to measure the analgesia. Methods 36 post-tracheal intubation patients requiring morphine titration in a medical ICU, were studied. 26 patients slept （S group） and 10 did not （A group）. Visual analogue pain scale （VAS）, Ramsay score （RS）, and the bispectral index （BIS） were recorded at the beginning of titration （TO）, 20, 40, and 60 min afterwards （T3）. When a patient reached RS≥2 during titration, morphine was discontinued. Results In both group, values of BIS and VAS statistically decreased between TO and T4. At T2 and T3, the changes in BIS were statistically different in the group S compared with the group A. The reduction in VAS was similar between groups. The components of VAS at T2 and T3 in group A were significantly different compared with group S. BIS had a statistically correlation with RS in both group A （P〈0. 01, r=-0. 80） and group S （P〈0. 01, r=-0. 83）, and with VAS in group S （P〈0. 05, r=0. 58）. There was no In post-tracheal intubation patients, BIS should not level of analgesia during i.v. morphine titration. correlation between BIS and VAS in group A. Conclusion be considered as an indicator of an appropriate correct