听觉诱发电位指数监测中发生脑电爆发抑制对机体的影响

The effect of electroencephalogram burst suppression in auditory evoked potential index monitoring to body

目的观察用听觉诱发电位指数(AAI)监测全身麻醉深度时,诱导期出现脑电爆发抑制,对其应激反应及术后全麻复苏的影响,即探讨爆发抑制出现后对机体的近期及远期影响。方法在全身麻醉下行腹部手术患者40例,根据患者全麻诱导时是否出现爆发抑制分为2组:爆发抑制组(A组)和未爆发抑制组(B组)。于各时间点采静脉血测定血糖、皮质醇(Cor)水平。术毕复苏期记录睁眼时间,拔管时间,拔管后1 min的镇静(OAA/S)评分情况。结果 9例患者全麻诱导时出现爆发抑制,占全部患者的22.5%,其中AAI最低值为3,均数为8,其余31例患者诱导期未出现爆发抑制。监测应激指标中,插管即刻(T1)的Cor值A组比B组有显著性降低,T1、手术开始即刻(T2)的血糖值A组比B组有显著性降低。在爆发抑制组内比较,T1、T2时点的血糖值比基础值(T0)比较有降低差异有显著性。术毕复苏指标2组比较差异无显著性。结论全身麻醉诱导期出现脑电爆发抑制可以短暂的抑制患者的应激水平,0.5 h后即可恢复,对术后全麻复苏时间和复苏质量无明显影响。

Objective To observe the auditory evoked potential index （AAI, A-line audi- tory index） monitoring general anesthesia, and the effect of electroence phalogram（EEG） burst sup- pression to stress response and recovery. Methods Forty cases of general anesthesia for abdominal surgery, according to whether the induction of anesthesia in patients with burst suppression occurs, were divided into two groups： burst suppression group （A） and no - burst suppression group （B）. Serum samples that were collected at each time tended to test the levels of blood glucose and cortisol. Eye opening time, extubation time in surgery recovery time and 1 min after extubation of the OAA/S score situation were recorded. Results Induction of anesthesia, there were 9 cases （22. 5% ） with burst suppression, in which the lowest AAI value was 3, with a mean of 8, and the re- maining 31 patients during induction did not have burst suppression. During monitoring stress indi- cators, immediate intubation （T1） of the cortiso[ values in group A significantly reduced than in group B, the blood glucose values in T1, immediately began surgery （T2） in group A significantly reduced than in group B. In the burst suppression group comparison, T1, T2 time point compared with baseline blood glucose values （T0） reduced more, and the difference was significant. Surgery recovery index difference had no significant between the two groups. Conclusion EEG burst sup- pression can transient suppression of patients with stress Restoration is performed in half an hour. There is no significant effect on anesthesia recovery time and quality of recovery after anesthesia on the EEG burst suppression.