脑电双频指数在颅脑手术麻醉中的应用

Application of Monitoring Bispectral Index of Electroenphalogram to Anesthesia during Neurosurgical Operation

目的评价以脑电双频指数(BIS)指导用药在颅脑手术麻醉中的作用。方法20例择期行脑肿瘤切除手术病人,随机分为2组,每组10例。对照组采用靶控输注(TCI),维持异丙酚血浆靶浓度为2.0μg/ml;BIS组根据BIS值调整麻醉深度,保持BIS值为50。监测心电图(ECG)、平均动脉压(MAP)、心率(HR)、脉搏、血氧饱和度(SpO2)及BIS值。分别在麻醉前(T1)和手术中(T2)各取血8ml,用放免分析法测定血糖、血管紧张素Ⅰ(AngⅠ)。记录各组药物用量及术毕停药到清醒时间。结果两组病人MAP、HR、SpO2均保持平稳。与麻醉前相比,两组病人术中血糖及AngⅠ水平均明显上升(P<0.05),但组间比较差异无显著性(P>0.05)。BIS组药物用量及停药到清醒时间均明显少于对照组(P<0.05)。结论以BIS作为反馈调控能减少麻醉维持中麻醉药物用量,有利于手术效果和病情变化的准确判断。

Objective To explore apphcation of monitoring bispeetral index （Bis） of eletroenphalogram （EEG） to anesthesia during neurosurgical operation. Methods Twenty ASA Ⅰ-Ⅱ patients undergoing neurosurgery for intracranial tumors were randomly divided into both the control and BIS groups of 10 patients each. The target-controlled infusion （TCI） of propofol was performed and its plasmatic target concentration of 2.0 μg/ml was kept in the control group. The infusion of propofol was adjusted according to EEG BIS value which was set at 50 in BIS group. ECG, mean arterial blood pressure （MAP）, heart rate（HR）, saturation of pulse oxygen（SpO2） and BIS were monitored during the operation. The levels of blood glucose（Glu） and angiotensin Ⅰ （AngⅠ ） were monitored before and during the operation. After the operation, propofol and fentanyl consumptions were calculated. The time of recovery from anesthesia after stopping administering drugs were recorded. Results There were insignificant differences in the blood levels of Glu and Ang Ⅰ between both the groups （P〉0.05）. The consumptions of propofol and fentanyl and the time of recovery from anesthesia were significantly less in BIS group than those in the control group （P〈0.05）. Conclusion Application of BIS to anesthesia during neurosurgical operation may effectively reduce propofol and fentanyl consumptions and the time of recovery from anesthesia and maintain hemodynamic stable in the patients with intracranial tumors.