A-Line麻醉深度监测仪在肌松监测中的临床应用

The clinical application of A-Line anaesthesia depth monitor on muscle relaxants

目的探讨A-Line麻醉深度监测仪是否可以在监测麻醉深度的同时监测肌松程度。方法随机抽取美国麻醉医师协会(ASA)Ⅰ～Ⅱ级的30例全身麻醉患者,应用麻醉深度监测仪和肌松监测仪在整个麻醉期间监测听觉诱发电位指数(AAI)、肌电活动指数(EMG)、四脉冲刺激模式(TOF)的值,重点观察诱导期、苏醒期、以及反应期这些指标的变化,并且分析其相关性。结果 30例全麻的患者在诱导期和苏醒期时EMG与AAI、TOF均有一定的相关性;在反应期EMG与AAI很好相关而与TOF没有相关性。反应期经过处理,EMG与TOF在给予肌松药前后,差异均有统计学意义,与AAI无统计学意义;EMG与AAI在给予镇静药前后差异均有统计学意义,与TOF无统计学意义。结论 A-Line麻醉深度监测仪在临床麻醉中不仅可以用于判断意识深度,而且可以监测到EMG来大致判断诱导期、苏醒期以及反应期的肌松程度。

Objective To investigate the effects of A-Line monitor on the depth of anesthesia and the degree of muscle relaxation.Methods 30 cases of ASAⅠ～Ⅱgrade were randomly selected to monitoring the auditory evoked poten-tials index（AAI）,eletromyography activity index（EMG） and four-pulse stimulation mode（TOF） during anesthesia by using the A-Line monitor,and focused on these indexes in anesthesia induction,emergence and response,and analyzing its relevance.Results EMG,AAI and TOF of the 30 cases in the anesthesia induction and recovery period has a certain correlation.In the reaction period EMG was associated with AAI and not correlated with TOF.Response of processed,after being given muscle relaxants,EMG and TOF were significantly different,but not with the AAI.Before and after being given sedative,the differences between EMG and AAI were significant,but not with the TOF.Conclusions A-Line monitor depth of anesthesia not only in clinical anesthesia awareness can be used to determine the depth,but also can monitor the EMG to largely determine the induction,emergence and the reaction of the degree of muscle relaxation.