脑电双频指数的临床矛盾性评价

The research progress of clinical evaluation of bispectral index

背景 1996年10月,美国食品药品管理局批准BIS监护仪用于临床监测镇静效应.BIS的临床使用减少了术中知晓,改善了患者术后恢复,提高了围手术期安全性,但临床应用发现,BIS数值和变化与临床表现有时并非一致（即矛盾性）. 目的 对引起BIS矛盾性变化的原因进行阐述,以指导临床应用. 内容 原因可能与全身麻醉药的药理特点、作用部位、频谱干扰、特殊病理生理状态（包括低血糖、脑缺血、低血容量、神经功能障碍等）及年龄、手术方式、血管活性药物等诸多因素有关. 趋向 鉴于BIS的矛盾性,如何利用BIS监测或联合其他监测手段加强特殊人群麻醉管理,是需要积极思考的问题.

Background US Food and drug administration approved the clinical application of BIS monitor for monitoring the pharmacodynamics of anesthetics and sedatives in October 1996.The application of BIS effectively reduced the occurrence of intraoperative awareness,and improved the postoperative recovery of patients and the perioperative safety.However,it was found that the values and changes of BIS were paradoxical in some clinical scenes.Objective To expound the reasons of the paradoxical changes of BIS values.Content The reasons might be related to many factors,including pharmacological characteristics and the effect site of anesthetics,interference,special pathophysiologic state （e.g.hypoglycemia,brain ischemia,low blood volume and neurological dysfunction）,age,operation,and vasoactive drugs.Trend We still need to actively think about how to use BIS monitoring or combine it with other monitoring measures to improve the anesthetic management and the prognosis in particular cases.