脑电非线性指数与双频谱指数用于麻醉深度监测的临床比较研究

Monitoring Depth of Anesthesia:A Comparision Between Electroencephalographic Nonlinear Index and Bispectral Index

目的评价脑电非线性指数(ENI)作为一种新的监测麻醉深度指数的有效性和准确性。方法纳入30例行择期开腹手术患者。每一患者同时监测ENI和经典脑电参数脑电双频谱指数(BIS)。用预测概率Pk值分别比较ENI、BIS、平均动脉压(MAP)和心率(HR)区分不同麻醉状态(清醒、睫毛反射消失、反应消失、稳态麻醉、麻醉苏醒时第一反应及气管拔管)的能力。用Spearman等级相关分析评价整个麻醉过程中ENI和BIS的相关性。比较ENI和BIS临床性能指标(成功率、反应率和恢复时间)。结果ENI和BIS区分不同麻醉状态的能力优于MAP和HR。麻醉过程中ENI与BIS有很好的相关性(r=0.93)。ENI与BIS的成功率和反应率差异无统计学意义;ENI的恢复时间短于BIS(P<0.05)。结论ENI可提供与BIS相似的反映麻醉深度的信息,能准确区分不同麻醉状态,其临床性能指标优于BIS。ENI是一个有效的、能准确反映麻醉深度变化的脑电参数。

Objective To compare the efficiency and accuracy of electroencephalographic nonlinear index （END and bispectral index （BIS） in monitoring depth of anesthesia during general anesthesia. Methods Thirty patients undergoing elective abdominal surgery were recruited. The ability of ENI and BIS to distinguish between the anesthetic states （awake, loss of eyelash reflex, loss of response, steady anesthesia, first reaction and extubation） was analyzed with prediction probability （Pk）. Correlation between ENI and BIS was tested by nonparametric Spearman rank correlation analysis, with data paired from awake through to extuhation. The clinical performances of ENI and BIS were evaluated with success rate, responsiveness, and recovery time. Results ENI and BIS were better than mean arterial pressure （MAP） and heart rate （HR） for distinguishing between the states of anesthesia. ENI correlated strongly with BIS from the stage of awake through to extubation （r= 0. 93）. No differences were found between ENI and BIS in success rate and responsiveness; but the recovery time was shorter with ENI than with BIS. Conclusion ENI and BIS provide similar information reflecting the states of anesthesia, which allowsaecurate distinguishment between different states of anesthesia. The clinical performance of ENI is better than that of BIS.