脑状态指数和麻醉趋势指数用于诱导期镇静深度监测的临床研究

Clinical study of cerebral state index and narcotrend index on sedation depth

目的观察脑状态指数和麻醉趋势指数在丙泊酚诱导期间意识水平变化的预测能力。方法选择ASAⅠ～Ⅱ级25例行腹腔镜胆囊切除的患者,予以丙泊酚靶控输注诱导,靶浓度从0.5μg/mL开始递增,递增梯度为0.5μg/mL,直至改良清醒镇静评分(OAA/S)为0后停止,连续监测患者在丧失语言反应(LVC)及意识消失(LOC)时的CSI、NTI和预测效应部位浓度(Ce)。结果 CSI、NTI、Ce与OAA/S评分相关性良好,预测概率(PK)分别为0.90±0.03,0.91±0.03,0.92±0.04,与PK=0.5比较,P<0.01。结论 CSI和NTI以及Ce均可反映丙泊酚靶控输注时镇静深度的变化,CSI和NTI虽然相关性良好,但存在一定的偏差。

Objective To study the correlation among the cerebral state index, the Narcotrend index and the predicted effect site concentration during different state of consciousness in the anesthetic induction in patients undergoing laparoscopic cholecystectomy. Methods Twenty-five classed ASA I or Ⅱ patients were anesthetized with target controlled infusion of propofol, the propofol infusion was set at all initial effect site concentration of 0.5 μg/mL and increased by 0.5 9g/mL every four min until the modified observees assessment of alertness/sedation scale （OAA/S） values of zero. The values of CSI, NTI and the predicted effect site concentration of propofol were recorded at LVC and LOC. Results The values of CSI, NTI and the predicted effect site concentration （Ce） had a good linear correlation with OAA/S. The prediction probability （PK） were 0. 90 ± 0. 03, 0. 91±0. 03, 0. 92±0. 04 respectively, Pk=0. 5 （P〈0.01）. Conclusion The values of CSI, NTI and Ce can reflect the sedation level of propofol. Although there is a significant correlation between CSI and NTI, a deviation does exist in a certain range.