听觉诱发电位指数在麻醉深度监测中的作用

Role of auditory evoked potential index in monitoring anesthesia depth

目的观察腹腔镜胆囊切除术(LC)中丙泊酚靶控输注(TCI)或异氟醚吸入维持麻醉期间听觉诱发电位指数(AAI)在麻醉深度监测中的作用。方法33例ASAⅠ级择期行LC的患者,随机分为两组:异氟醚组(I组)18例行诱导插管吸入全麻,丙泊酚组(P组)15例诱导插管同I组;麻醉维持分别用异氟醚与氧化亚氮吸入或丙泊酚靶控输注与氧化亚氮吸入。通过调节异氟醚吸入浓度或丙泊酚靶控输注浓度使麻醉期间MAP、HR波动在基础值±20%范围内,记录麻醉期间异氟醚呼气末浓度、丙泊酚靶控输注浓度及AAI值。结果两组AAI值均较低,P组出现一过性AAI值≤10有12人次,I组则有4人次;且AAI值与丙泊酚靶控输注浓度及异氟醚呼气末浓度呈负相关(P<0.05),与MAP、HR无明显相关。结论结合AAI监测可更全面的反映麻醉深度。

Objective To study the role of auditory evoked potential index （AAI） in monitoring anesthesia depth during anesthesia maintained with propofol target-controlled influsion （TCI） or isoflurane inhalation. Methods Thirty-three ASA class I patients scheduled for selective laparoscopic cholecystectomy （LC） were randomly allocated to two groups. Group I（n= 18）： anesthetized with inhalation of isoflurane and nitrous oxide, and Group P（n= 15）.- anesthetized with propofol TCI and nitrous oxide inhalation. The concentration of isoflurane inhalation or propofol TCI was adjusted to keep the MAP, HR within the range of 20‰ the basic levels. The end-tidal concentration of isoflurane,TCI concentration of propofol and the AAI values were recorded. Results The values of AAI were aU lower with a transient AAI ≤10 12 times in the group P and 4 times in the group I. The values of AAI were negatively correlated with the concentration of propofol TCI and the end-tidal concentration of isoflurane （P〈0. 05）,but had no correlation with MAP and HR. Conclusion AAI monitoring combined with other parameters can reflect the depth of general anesthesia more sufficiently.