脑电双频指数在老年患者异氟烷复合诱导中的应用

Bispectral index of induction supplemented with isoflurane in old-age patients

目的探讨比较在异氟烷复合诱导的老年病人中不同脑电双频指数（BIS）下行插管时的血流动力学变化。方法选择ASAⅠ～Ⅲ级择期全麻病人60例，年龄65-77岁。随机分为3组，每组20例。诱导时先给予咪达唑仑0．04mg／kg，芬太尼1μg／kg同时给予异氟烷自主吸入，并调节异氟烷吸入浓度，使BIS 3～5min达到设定的不同目标值（A组50-60，B组40-50，C组30-40）后，立即给予芬太尼2μg／kg，琥珀胆碱1mg／kg。45s后行气管插管。麻醉监测心率（HR）、平均动脉压（MAP）、BIS、呼气末异氟烷浓度（EtISO）。结果各组插管后BIS均明显升高（P〈0．05），A组BIS值甚至超过60以上。C组MAP下降最明显，且一直持续到插管后5min，其MAP与A、B组相应时间相比仍有显著差异（P〈0．05）。结论以BIS监测对老年人的异氟烷复合诱导有一定的指导作用，但过深的麻醉将对老年患者的循环产生明显抑制。

Objective To investigate the changes in hemodynamics under different bispectral indexes（BIS） for endotracheal intubation during combined induction with isoflurane in old-age patients. Methods Sixty ASA Ⅰ-Ⅲ old patients under going elective surgery under general anesthesia were enrolled in this study. The patients were randomly divided into 3 groups（n = 20 in each group） ： group A（BIS 50-60）, group B（BIS 40-50） and Group C（BIS 30-40）. Midazolam（0. 4 mg/kg）, fentanvl（1 μg/kg） and scoline were administered for induction. BIS, MAP, HR and EtISO were monitored continuously in 3 groups. Results All BIS were increased significantly after endotracheal intubation（P〈0. 05）. MAP was decreased significantly in group C （P〈0. 05） as compared with other two groups（P〈0. 05）. Conclusion BIS can be used as an effective indicator to evaluate cardiovascular effects for endotracheal intubation during combined induction with isoflurane in old-age patients.