脑电双频指数指导地氟醚与七氟醚麻醉的可行性

Feasibility of application of bispectral index to titrating desflurane or sevoflurane anesthesia

目的 了解脑电双频指数是否可用于指导地氟醚与七氟醚麻醉。方法 40例择期病人 ,随机分成四组 (n =10 ) :组I为地氟醚指导组 (Des t) ,组Ⅱ为地氟醚对照组 (Des c) ,组Ⅲ为七氟醚指导组 (Sevo t) ,组Ⅳ为七氟醚对照组 (Sevo c)。对照组仅凭临床经验来调定地氟醚与七氟醚浓度。指导组则通过维持BIS在 6 0左右来调定吸入麻醉药浓度。记录麻醉期间血压、心率及BIS变化 ,并记录各麻醉药用量。结果 指导组收缩压明显高于对照组 (P <0 0 5 ) ,且波动幅度较对照组大。对照组BIS明显低于指导组 (P <0 0 5 ) ,但麻醉维持过程相对较平稳 ,镇痛药与肌松药用量明显少于指导组。结论 BIS可为地氟醚与七氟醚麻醉镇静与睡眠的深度提供量化指标 。

Objective To assess the feasibility of using bispectral index (BIS) to guidance of desflurane or sevoflurane anesthesiaMethods Forty ASA Ⅰ-Ⅱ patients were randomly assigned to four groups, After a induction of propofol 2-2·5mg·kg -1 and fentanyl 2ug·kg -1, laryngoscopy and intubation were facilitated with intravenous vecuronium 01mg·kg -1,and anesthesia was maintained with either desflurane or sevoflurane in combination with 60% nitrous oxide In control groups, the anesthesiologists were blinded to the BIS value, and the volatile anesthetics were administered according to their clinical experience In BIS-titrated groups, the volatile anesthetics were titrated to maintain the BIS value at about 60Results During the maintenance period, the SBP in BIS-titrated groups was higher than that in control groups, while SBP fluctuation was less in control groups than that in BIS-titrated groups The requirements of volatile anesthetics were lower in BIS-titrated groups than those in control groupsConclusions In spite of predicting the sedative effect of desflurane or sevoflurane, BIS can not titrate desflurane or sevoflurane anesthesia