两种麻醉镇静深度监测技术在全麻中的应用比较

Two kinds of anesthetic sedative depth monitoring technology in the application of general anesthesia

目的通过临床分析手术期间全身麻醉下脑电双频指数（Bls）和麻醉深度指数（CSI）的变化来调整麻醉药用量,评价BIS、CSI在监测麻醉深度方面的实用性。方法随机选择2013年5月—2014年11月该院收治的拟在丙泊酚与瑞芬太尼麻醉下施实气管内插管的全麻患者160例,按照瑞芬太尼靶浓度随机均分为4组：R1组（0.9%氯化钠）、R2、R3、R4组分别为2.0μg/（kg·min）、3.0μg/（kg·min）、4.0μg/（kg·min）瑞芬太尼。结果随着4组患者OAA/S评分的降低,BIS、CSI也逐渐降低（P〈0.05）;同时OAA/S评分下,R2-R4组的BIS、CSI高于R1组（P〈0.05）。Speaman等级相关分析结果表明：BIS或CSI与OAA/S评分有相关性,但各组间相关系数比较差异无统计学意义。R1-R4组患者在睫毛反射消失及强直刺激反应消失时的CSI、BIS均高于R1组。结论CSI与BIS相似,能较好地反映全麻手术患者镇静深度的变化;两者的变化均受到血浆镇痛药物浓度改变的影响,与OAA/S评分相关性一致。

Objective through clinical observation during surgery under general anesthesia electrical dual-frequency （Bls） and the anesthesia depth index （CSI） changes to adjust drug dosage, evaluation the BIS, the practicability of CSI in monitoring the depth of anesthesia. Methods Random selection in propofol anesthesia with fentanyl ShiShi endotracheal intubation of 160 cases of patients with general anesthesia, according to the red target concentration of fentanyl randomly were divided into four groups： R1 group （0.9% sodium chloride）, R2：, R3 and R4 group were 2.0, 3.0, 4.0 mu g/（kg＆#183;min） fentanyl. The results of With the loss of the OAA/S score four groups of patients, the BIS, CSI also gradually reduced（P〈0.05）;OAA/S score at the same time, the BIS, CSI is higher than the R1, R2 and R4 group group （P 〈 0.05）. Speaman rank correlation analysis results show that the BIS or CSI has correlation with OAA/S score, but there was no statistically significant difference in the correlation coefficients between each group. R1 and R4 patients disappeared in eyelash reflex and tetanic stimulation reaction disappears CSI, BIS were higher than in R1 group. Conclusion CSI is similar to the BIS, can well reflect the general anesthesia surgery patients sedation depth change;Change of both types of influenced by analgesic drug plasma concentration changes, consistent with OAA/S score correlations.