脑电双频谱指数监测提高麻醉管理及全麻苏醒质量Meta分析研究

Bispectral index improves anesthetic management and facilitates recovery from general anesthesia of Meta-analysis study

目的评价脑电双频谱指数(BIS)监测是否改善麻醉管理和麻醉苏醒质量。方法按照制定的检索策略检索Pubmed和Medline-CDRom数据库(1990年1月至2004年1月),随后按照一定的入选原则找出符合要求的文献。按已制定的研究评价标准进行筛选,共10篇文献纳入最终的Meta分析。结果BIS监测在镇痛药用量一致的情况下可减少催眠药物的用量。吸入麻醉中BIS监测可减少吸入麻醉药用量,但肌松药用量增加。BIS组病人睁眼时间、言语指令反应恢复时间、拔管时间、定向力恢复时间均缩短。BIS监测对术后恶心呕吐及术后疼痛的发生率没有影响。BIS监测减少术中知晓与术后记忆发生的证据尚不足。结论BIS监测能减少全身麻醉中药物用量并提高麻醉苏醒质量。

Objective To investigate if bispectral index （BIS） improves anesthetic management and the outcome of the patients. Methods Published studies on BIS monitoring during surgery were identified by electronic searching in Pubmed and Medline-CDRom from 1990 to January 2004. After assessment of quality of the studies only 10 studies were accepted for meta-analysis. Results BIS monitoring during surgery might reduce the amount of hypnotics without increasing the amount of narcotics. BIS monitoring increased the amount of muscle relaxants used during inhalational anesthesia. The time from termination of anesthesia to eye opening, response to verbal command, orientation and tracheal extubation were significantly shorter in BIS group. BIS monitoring did not reduce the amount of inhalational anesthetics. There was no significant difference in the incidence of nausea and vomiting and postoperative pain between groups with and without BIS monitoring. There were not enough evidences showing that BIS could reduce intraoperative awareness and postoperative recall. Conclusion BIS monitoring during general anesthesia reduces the amount of general anesthetics and improves recovery from anesthesia.