脑电双频指数(BIS)指导七氟醚用于颅内手术麻醉

Feasibility of application of bispectral index to titrate Sevoflurane anesthesia in intracranial operations

目的该文拟探讨脑电双频指数(bispectralindex,BIS)指导七氟醚麻醉在颅内手术的可行性。方法选用40例18～60岁,ASAⅠ、Ⅱ级择期行颅内肿瘤摘除术的患者,随机分为指导组(BIS组)和对照组,每组20例。对照组根据同一麻醉医生的临床经验来调整七氟醚的吸入浓度,指导组则通过BIS维持在(55±5)左右来调定七氟醚浓度,记录麻醉期间血压、心率以及BIS的变化,并测量记录2组患者七氟醚的用量。结果指导组平均动脉压明显高于对照组,但对照组平均动脉压及心率波动幅度较大,指导组的BIS值明显高于对照组,但麻醉过程相对平稳,七氟醚以及镇痛药的用量指导组也明显少于对照组。结论BIS可为七氟醚用于颅内手术麻醉镇静深度提供量化指标。

[Objective] To assess the feasibility of using bispectral index （BIS） to guide Sevoflurane anesthesia in intracranial operations. [Methods] Forty ASA Ⅰ～Ⅱpatients were randomly assigned to two groups. After an induction of midazolam 0.1 mg/kg, propofol 2 mg/kg and fentanyl 4 μg/kg, laryngoscopy and intubation were facilitated within travenous vecuronium 0.1 mg/kg, and anesthesia was maintained with sevoflurane. In control groups, the anesthesiologists were blinded to BIS value, and the volatile anesthetics were administered according to physicians＇ clinical experience. In BIS-titrated groups, the volatile anesthetics were titrated to maintain the BIS value at about （55±5）. [Results] During the maintenance period, the MAP in BIS-titrated groups was higher than that in control groups, while MAP fluctuation was greater in control groups than that in BIS-titrated groups. The requirements of volatile anesthetics were lower in BIS-titrated groups than those in control group. [Conclusions] BIS can not only predict the sedative effect of Sevoflurane, but also titrate Sevoflurane anesthesia.