脑电双频指数指导七氟醚用于颅脑手术病人麻醉

Application of bispectral index to titrating Sevoflurane anesthesia in intracranial operations

目的研究脑电双频指数(BIS)指导吸入七氟醚用于颅脑手术麻醉的可行性。方法选择择期行颅内肿瘤切除术的患者40例,ASAⅠ、Ⅱ级,随机分为对照组和BIS组,每组20例。对照组由同一麻醉医生根据经验调节术中七氟醚的吸入浓度;BIS组术中维持BIS在50～60,手术结束前20min,BIS维持在60～70。记录诱导前、麻醉期间和拔管时的BIS、七氟醚呼气末MAC(MACET);麻醉后清醒、拔除气管导管和定向力恢复的时间。结果与对照组比较BIS组诱导前、拔管时BIS差异无显著性,麻醉期间对照组BIS值较BIS组低,MACET较BIS组高;BIS组睁眼时间、拔管时间和定向力恢复时间较对照组缩短。结论BIS可以指导七氟醚用于颅脑手术患者围术期,并能加快颅脑手术患者麻醉后的恢复。

[Objective] To investigate the effect of BIS monitoring during Sevoflurane anesthesia in patients undergoing elective intracal surgery. [Methods] Forty ASA Ⅰ - Ⅱ patients undergoing elective intracal surgery were randomized to one of two groups （n = 20, each）： BIS group and control group. In BIS group Sevoflurane was titrated to keep BIS values between 50-60 during operation, but in control group the anesthesiologist was blinded to the BIS score. The BIS value was increase to 60-70 at 20 min before the end of operation. In control group the depth of anesthesia was maintained based on the clinical experience of the anesthesiologist. The BIS values and the end-tidal Sevflurane MAC （MACET） before and during anesthesia and at extubation, emergence time, extubation time and orientation resume time were recorded and compared between the two groups. [Results] The average BIS values were higher and end-tidal Sevoflurane concentration was lower in BIS group than in control group. The time from the end of surgery to eye opening, to exbuation and orientation resume were significantly shorter in BIS group than in control group. [Conclusion] Titration of Sevoflurane using BIS monitoring can be used in patients undergoing elective intracal surgery, and also contribute to faster recovery from anesthesia.