心率变异性复杂度分析和脑电双频谱指数在监测全身麻醉时的相关性

Correlation between Monitoring Parameters of Complexity of Heart Rate Variability and Bispectral Index during General Anesthesia

目的:观察全身麻醉时心率变异性分析中复杂度和脑电双频谱指数(BIS)的变化,探讨复杂度和BIS在监测麻醉深度时的相关性。方法:30例全身麻醉病人,测定麻醉前(T1)、诱导插管(T2)、术中(T3)、苏醒(T4)4个时间点各5min的心率(HR)、平均动脉压(MAP)、脑电双频谱指数(BIS)和复杂度变化。结果:HR在T2、T3和T4较T1值升高(P<0.01或0.05)。MAP在T2时较T1值降低(P<0.05),T3和T4较T1值升高(P<0.05),而T3和T4相比变化较大(P<0.01)。BIS值在各时点较T1值下降明显(P<0.01),其中T4较T1略下降(P<0.05),T3与T2时相比明显降低(P<0.01),而T4较T3明显升高(P<0.01)。复杂度值的T1值均大于各个点(P<0.01或0.05),其T4较T2和T3时升高(P<0.05),T3较T2时升高(P<0.05)。结论:作为心率变异性非线性指标的复杂度能描述围术期心脏自主神经功能状态的变化,但其与BIS并无相关性。

Objective To compare the changes of complexity and bispectral index （BIS） during general anesthesia, and to estimate the relationship between complexity and bispeetral index in monitoring the depth of anesthesia Methods HR, MAP, BIS and complexity were monitored and recorded before induction （T1）, induction and intubation （T2）, operation （T3） and analepsia （T4） of 30 patients of ASA I - II with general anesthesia. Results Compared to T1, the HR was increased at the other time - points. The value of MAP at T2 was lower than that at T1, and at T3 and T4 higher than at T1, but the value of T3 was significantly different from that of T4. Compared to T1 the value BIS at the other time - points was decreased, and at T4 lower than at TI, at T3 significantly lower than At T2, but at T4 higher than At T3. The value of complexity at Tl was higher than that at the other time - points and at T4 higher than at T2 and T3. Con- clusion As the parameter of the nonlinear analysis of heart rate variability, the complexity can describe the functional status changes of the autonomic nerve system, but it showed no relationship to BIS.