听觉诱发电位和脑电双频指数用于预先镇痛后全麻恢复期意识恢复程度的比较

Comparison between the performance of bispectral and auditory evoked potential to predict the level of consciousness after preemptive analgesia during recovering period

目的 脑电双频指数（BIS）和听觉诱发电位（AEP）监测预先镇痛后全麻恢复期意识恢复程度的比较。方法 选择40例ASAⅠ-Ⅲ级行金子宫切除术的患者，随机分为对照组（20例）和预先镇痛组（20例），所有患者均在静吸复合麻醉下完成手术。预先镇痛组在手术开始前使用曲马多1．5mg／kg，术后入苏醒室，记录BIS、AEP、VAS评分及术后寒颤和躁动的发生率。结果 （1）VAS评分：预先镇痛组优于对照组（P〈0．05）。（2）OAA／S评分、BIS和AEP：OAA／S评分和BIS在5rain和10rain两个时间点，预先镇痛组低于对照组（P〈0．05），而AEP在各个时间点，预先镇痛组均低于对照组（P〈0．05）。（3）术后寒颤和躁动的发生率：预先镇痛组明显低于对照组。结论 AEP和BIS均能够良好地反映患者的意识恢复程度，但BIS主要反映患者镇静程度，而AEP更能够综合反映患者镇静、镇痛程度。

Objective To observe whether preemptive analgesia affect recovering degree of awareness in postoperative patients. Methods Forty patients for complete hysterectomy were randomly assigned to control group （ n = 20） and preemptive analgesia group （ n = 20）. All patients had been completed the operations under general anesthesia. Before operation, patients in the preemptive analgesia group were given tramadol 1.5 mg/kg intravenously. After operation, all patients were transported into rer covering room. OAA/S sedation score, VAS, BIS and ratio of postoperative shaking chili and harass were recorded. Results （ 1 ） VAS： preemptive analgesia group was much better than control group （ P 〈 0.05 ）. （2）OAA/S and BIS were significantly lower in preemptive analgesia group than control group at 5 and 10 min ntes after extubation. But AEP was significantly lower in preemptive analgesia at all＇times after extubation. （3） The ratio of postoperative shaking chill and harass were also significantly lower in preemptive analgesia group than control group （P 〈 0.05 ）. Conclusion Both AEP and BIS can predict fairly well the level of consciences, during recovering periods after general anesthesia. But AEP is more comprehensive than BIS.