麻醉指数监测异丙酚镇静深度的准确性：与BIS的比较

Accuracy of anesthesia index for monitoring depth of sedation induced by propofol： a comparison with bispectral index

目的评价麻醉指数（AI）监测异丙酚镇静深度的准确性。方法全麻下行择期手术患者30例，性别不限，年龄41～64岁，体重指数20～30 kg/m2，ASA分级Ⅰ或Ⅱ级。采用Marsh药代动力学参数TCI异丙酚，设定初始Ce为1.2 μg/ml，待Ce稳定后以0.3 μg/ml为梯度递增，并行OAA/S评分。TCI异丙酚前，OAA/S评分为5分，TCI异丙酚期间OAA/S评分依次达4、3、2、1分时，分别记录BIS值、AI值及相应的Ce。结果BIS值、AI值、Ce与OAA/S评分的相关系数分别为rBIS-OAA/S＝0.962 、rAI-OAA/S＝0.960、rCe-OAA/S ＝－0.795（P〈0.05）；BIS值、AI值与Ce的相关系数分别为rBIS-Ce＝－0.736、rAI-Ce＝－0.737（P〈0.05）。rBIS-OAA/S及rAI-OAA/S之间、rBIS-Ce及rAI-Ce之间比较差异均无统计学意义（P〉0.05）。结论成年患者非伤害性刺激条件下，AI可准确监测异丙酚的镇静深度，且与BIS相比无明显差异。

Objective To evaluate the accuracy of anesthesia index（AI）for monitoring depth of sedation induced by propofol.Methods Thirty patients of both sexes, aged 41-64 yr, with body mass index of 20-30 kg/m2, of American Society of Anesthesiologists physical statusⅠorⅡ, scheduled for elective surgery under general anesthesia, were enrolled in the study.Propofol was given by target-controlled infusion（TCI）with the initial target effect-site concentration（Ce）of 1.2 μg/ml using Marsh pharmacokinetic model, and then the Ce of propofol was increased in 0.3 μg/ml increment, and Observer′s Assessment of Alertness/Sedation（OAA/S）score was evaluated.OAA/S score was 5 before TCI of propofol.When OAA/S score reached 4, 3, 2 and 1 in turn during TCI of propofol, the bispectral index（BIS）, AI and corresponding Ce were recorded.Results The correlation coefficients of BIS, AI and Ce levels with the OAA/S scores were rBIS-OAA/S=0.962, rAI-OAA/S=0.960 and rCe-OAA/S =-0.795, respectively（P〈0.05）. The correlation coefficients of BIS and AI with the Ce of propofol were rBIS-Ce=-0.736 and rAI-Ce=-0.737, respectively（P〈0.05）. There was no significant difference between rBIS-OAA/S and rAI-OAA/S, and between rBIS-Ce and rAI-Ce （P〉0.05）.Conclusion AI can accurately monitor the depth of sedation induced by propofol in adult patients without noxious stimuli and there is no significant change in the accuracy in comparison with BIS.