幕上肿瘤患者肿瘤侧和非肿瘤侧额部脑电双频指数的一致性

Comparison of bispectral index value from the tumor side with contralateral position during supratentorial craniotomy

目的比较神经外科幕上肿瘤切除术中肿瘤侧和非肿瘤侧额部脑电双频指数(bispectral index,BIS)是否具有一致性。方法择期行幕上肿瘤手术患者35例,男16例,女19例,年龄18~65岁,ASAⅡ或Ⅲ级。每位患者肿瘤侧和非肿瘤侧额部同时放置BIS电极。麻醉方法:静脉快速诱导,全凭静脉维持麻醉。记录麻醉手术过程中诱导前期、剪硬膜前、切瘤中、清醒后期四个阶段肿瘤侧和非肿瘤侧的BIS数据行Bland-Altman分析。结果 Bland-Altman分析显示:肿瘤侧与非肿瘤侧额部BIS诱导前平均偏差-0.8(-7.2~5.7);剪硬膜前平均偏差0.6(-8.3~9.5);切瘤期平均偏差1.5(-6.9~9.9);清醒后期平均偏差0.2(-9.3~9.8)。结论肿瘤侧与非肿瘤额部脑电双频指数具有良好的一致性,两者可互换。

Objective To evaluate the agreement of bispectral index values recorded from tumor side and the contralateral areas during supratentorial craniotomy. Methods Thirty-five patients （16 males, 19 females, aged 18-65 years, ASA physical status Ⅱ or Ⅲ ） scheduled for supratentorial tumor resection were enrolled in this study. Bispectral index （BIS） sensors were placed at bilateral frontal areas. The patients were anesthetized with propofol. From each BIS monitor, we collected data at each of four time stages： before the induction of anesthesia, before dura opening, removal of tumor and recovery of conscious. These data were compared using Bland-Altman analysis. Results Bland and Altman analysis revealed a BIS negative-bias （limits of agreement） of before induction -0. 8（-7. 2-5. 7）, before dura opening 0. 6 （-8. 3-9. 5）, and removal of tumor 1.5（-6. 9-9. 9）, recovery of conscious 0. 9, （-9. 3-9.8）. Conclusion There are significant agreement for BIS values between the frontal area of tumor side and the contralateral areas. BIS values can be used interchangeably between bilateral frontal.