Angel-6000型脑电麻醉深度监护仪与脑电双频指数临床应用比较

Study of the changes and correlation of index of consciousness and bispectral index during target-controlled infusion of propofol

目的:比较丙泊酚靶控输注实施全麻时意识指数(Index of consciousness,Io C)与脑电双频指数(Bispectral Index,BIS)的差异与相关性。方法:择期行腹腔镜胆囊切除全身麻醉患者35例,同时监测患者Io C与BIS。采用分步诱导法,丙泊酚TCI输注。记录并比较丙泊酚血浆浓度1.5μg/m L^4μg/m L时Io C与BIS的变化趋势及相关性。对比患者基础、意识消失、意识恢复以及插管前后Io C与BIS值变化情况。结果:患者基础Io C与BIS值比较未见显著差异(P>0.05),意识消失与意识恢复时两者均低于基础值(P<0.05)。意识消失时Io C值为49.9±4.35,低于BIS(P<0.05)。清醒时Io C为80.4±4.71,高于BIS(P<0.05)。随着丙泊酚血浆浓度升高Io C与BIS直线下降。丙泊酚血浆浓度4μg/m L时Io C为49.3±4.05,较前一浓度下降不明显(P>0.05),与BIS(42.7±6.65)比较差异有统计学意义(P<0.05)。不同浓度时BIS与lo C值的相关系数r为0.971(P<0.01),两者具有显著相关性。插管时Io C为55±5.37,高于插管前,并高于同期BIS值(P<0.05)。结论 :丙泊酚TCI实施全身麻醉时Io C能良好地反映患者意识水平,与BIS具有良好的相关性,能够实时反映气管插管刺激对于脑电的影响。

Objective： To study the changes of correlation between index of consciousness（IoC） and bispectral index（BIS） during target-controlled infusion of propofol. Methods： IoC and BIS of 35 patients undering laparoscopic cholecystectomy under general anesthesia were monitored simultaneously. Anesthesia was induced with TCI propofol. When the plasma propofol concentration increased from 1.5 μg/ml to 4μg/ml, The changes and corredation of IoC and BIS were compared in basic state at the, loss and recovery of consciousness and during intubation. Result： There was no significant difference in basic IoC and BIS（P〈0.05）. When patients were at the loss and recovery of consciousness, the IoC and BIS were lower than the basic value（P 〉0.05）. When patients lost of consciousness IoC was lower than BIS, but higher when consciousness recovered（P〈0.05）. With the increase of plasma concentration of propofol, BIS and IoC declined rapidly. However there was no significant decline of IoC when the plasma concentration of propofol approached 4 μg/ml. And there was significant difference comparinge with BIS（P〈0.05）. BIS and lo C had a significant correlation. During intubation IoC was higher than before intubation and higher than concurrent higher than concurrent BIS（P〈0.05）.Conclusion： IoC can reflect the level of consciousness accurately during target-controlled infusion of propofol.IoC has a good correlation with BIS, and can reflect noxious stimulation on EEG in real time.