BIS监测技术在CT引导下三叉神经半月节射频热凝术中的应用

Clinical study on bispectral index monitoring for painless-anesthesia during CT guided radiofrequency electrocoagulation for trigeminal neuralgia

目的探讨在CT引导下三叉神经半月节射频热凝术中使用脑电双频指数(BIS)监测丙泊酚复合芬太尼全凭静脉麻醉深度的可行性。方法选择50例择期行三叉神经痛CT引导下舍频热凝术患者,予芬太尼1.6μg/kg+丙泊酚1mg/kg诱导,丙泊酚以6mg/(kg·h)持续泵入。记录入室(T1)、穿刺定位(T2)、麻醉诱导(T3)、治疗第1次(T4)、治疗第2次(T5)、治疗第3次(T6)、治疗第4次(T7)、手术结束(T8)、睁眼(T9)、定向力恢复(T10)时的收缩压(SBP)、舒张压(DBP)、心率(HR)、血氧饱和度(SpO2)和BIS的变化。结果 BIS在T4、T5、T6和T7时下降,与T1相比有显著性差异(P<0.05)。结论 BIS可以指导、监测患者的麻醉镇静深度。丙泊酚复合芬太尼全凭静脉麻醉中将BIS维持在60～79即浅麻醉状态时可满足三叉神经痛CT引导下射频热凝术的麻醉要求。

Objective To monitor the anesthetic depth of propoful and fentanyl by bispectral index（BIS） during CT guided radiofrequency electrocoagulation in trigeminal neuralgia.Methods Fentanyl 1.6 μg/kg and Propoful 1 mg/kg were induced in fifty patients, the Propoful concentration was maintained at 8 mg/（kg·h） by continuous intravenous infusion.BIS、 blood pressure （BP）、heart rate （HR）and pulse oxygen saturation （SpO2） were measured before opration （T1）,during orientation （T2） induction, propoful infusion beginning （T3）, the first curing（T4）, the second curing（T5）, the third curing（T6）, the fourth curing（T7）, when the operation ended（T8）, eye opening（T9） and consciousness recovery （T10）.Results BIS at T4、 T5、T6 and T7 were decreased significantly when compared with that at T1 （P0.05）.Conclusions BIS can guide and monitor the depth of anesthesia depth.Propoful and Fentanyl are suitable agents for induction and maintenance during CT guided radiofrequency electrocoagulation in trigeminal neuralgia if BIS can be maintained around 60～79.