脑电双频谱指数和正中神经体感诱发电位监测窥喉插管应激反应的比较

Comparison of accuracy of bispectral index and median nerve somatosensory evoked potential for assass. ment of stress during laryngoscopy and tracheal intubation

目的比较脑电双频谱指数和正中神经体感诱发电位监测异丙酚诱导下窥喉插管所致应激反应的可行性和准确性。方法选择16-40岁ASAI-Ⅲ级无神经精神系流疾病患者15例，异丙酚和司可林麻醉后行气管插管，记录插管前、中、后的MnSSEP、BIS、SBP、DBP、HR。结果插管即刻MnS，SEP的P15N20、N20P25波幅增高，插管后N20P25恢复，P15N20仍增高，其余波幅无改变。插管前后MnSSEP各波潜伏期均无改变，并BIS无明显改变。插管即刻和插管后SBP、DBP较插管前增高而HR无明显改变。结论正中神经体感诱发电位的N20P25适于反映气管插管对神经系统的影响，P15N20适于反映气管插管对心血管系统的影响，BIS值不能反映窥喉插管的应激反应。

Objective To comparison of accuracy of bispectral index and median nerve somatosensory evoked potential for assassment of stress during laryngoscopy and tracheal intubation. Methods Fifteen ASA Ⅰ - Ⅱ patients aged 16-40 yrs undergoing elective surgery under general anesthesia. Anesthesia was induced with TCI propofol. After the target effect-site concentration of propoful reach 6 μg/ml and maintained for two mi- nutes,intubation was facilitated. Results There were no changes in all latencies of MnSSEP, BIS and HR. Dur- ing intubation, amplitudes of N20P25 increased, and after that they reinstated. SBP, DBP and P15N20 increased during and after intubation. Conclusion N20P25 is suitable to reflect the effects of intubation to nerve system. P15N20 is suitable to reflect the effects of intubation to cardiovascular system. BIS can not reflect the stress of intubation.