脑电双频指数监测在老年患者静脉麻醉中的应用研究

Study on application of the bispectral index monitor during intravenous anesthesia in elderly patients

目的探讨脑电双频指数监测(BIS)在老年患者麻醉手术期间应用的临床价值。方法选择择期全麻下行直肠癌根治手术患者60例,随机分为BIS组和对照组,各30例,BIS组连接麻醉深度监护仪在麻醉手术期间通过连续监测BIS、对照组根据患者血压及心率的变化调节给药剂量调控麻醉深度。监测指标:两组患者入室、插管前即刻、插管后1 min、麻醉期间血压、心率、血氧饱和度、术毕拔管时间、术后1、2 h麻醉恢复和简易智能评分。结果麻醉诱导期BIS组丙泊酚用量、血压下降的程度、术中低血压发生的频率明显低于对照组(P<0.05)。BIS组术毕拔管时间、麻醉恢复时间短于对照组,手术后1、2 h简易智能状态(MMSE)评分高于对照组(P<0.05)。丙泊酚总用量BIS组少于对照组(P<0.05)。结论对老年患者麻醉手术期间应用BIS监测麻醉深度调控麻醉用药,可预防麻醉过深。

Objective To explore the clinical value of electroencephalogram bispectral index（BIS）during anesthesia and surgery in elderly patients.Methods Sixty patients undergoing radical cure of rectum cancer anesthetized with propofol were randomly divided into two groups：BIS group（n=30）and control group（n=30）.The doses of propofol were adjusted according to the BIS values in BIS group,and the changes of blood pressure and heart rate in the control group,respectively.The non-invasive blood pressure,heart rate and SpO2 were recorded respectively at different times：the patients entering the operation room,immediately before intubation,1 min after intubation and during the surgery period in both groups.We also recorded the extubation time,mini-mental state examination（MMSE）scores at one hour and two hours after operation.Results The doses of propofol required for the induction of anesthesia,the degree and incidence of hypotension during operations of BIS group were significantly lower than those of control group（P0.05）.The BIS group received less extubation time and higher MMSE scores at both one hour and two hours after surgery compared with controls（P0.05）.The total doses of propofol used during operation were lower in BIS group（P0.05）.Conclusion Monitoring the depth of anesthesia to adjust the doses of anesthetic drugs using BIS analysis during anesthesia and surgery in elderly patients can prevent over-anesthesia,and increase the anesthesia security.