脑电双频指数监测在老年患者全麻恢复期气管拔管中应用价值分析

Application Value of Bispectral Index Monitoring in Tracheal Extubation in Elderly Patients During General Anesthesia Recovery

目的探讨脑电双频指数监测在老年患者全麻恢复期气管拔管中的应用价值。方法应用随机分组方法将方便选取2017年1月—2018年4月该院收治的需要气管插管全麻手术的老年患者64例平均分为两组,皆在手术室给予气管拔管,保持拔管时脑电双频指数对照组为80以上,观察组为60～80,对比研究两组患者术前与拔管后最高值的平均动脉压、心率。结果术前两组患者的心率分别为(75.8±7.1)次/min与(76.1±6.9)次/min,差异无统计学意义(t=0.171,P=0.865),术前两组患者的平均动脉压分别为(89.8±8.4)mmHg与(90.2±8.5)mmHg,差异无统计学意义(t=0.189,P=0.850);拔管后两组患者的心率最高值分别为(85.6±8.2)次/min与(96.2±8.5)次/min,差异有统计学意义(t=5.077,P=0.000),拔管后两组患者的平均动脉压最高值分别为(99.2±8.7)mmHg与(107.9±9.1)mmHg,差异有统计学意义(t=3.909,P=0.000)。结论针对老年患者在全麻恢复期气管拔管时给予脑电双频指数监测,保持脑电双频指数监测在60～80之间,能够降低拔管时对患者心血管带来的刺激程度,为患者拔管期的安全提供保障,临床上推广应用很有价值。

Objective To investigate the value of bispectral index monitoring in tracheal extubation in elderly patients dur- ing general anesthesia recovery. Methods A total of 64 elderly patients requiring tracheal intubation and general anesthesia admitted to the hospital from January 2017 to April 2018 were convenient selected and divided into two groups. All patients were given tracheal extubation in the operating room. The EEG dual-frequency index control group was 80 or more, and the observation group was 60 to 80. The mean arterial pressure and heart rate of the highest values before and after extubation were compared between the two groups. Results The heart rate of the two groups before operation was （75.8±7.1） times/rain and （76.1±6.9） times/rain ,the difference was not statistically significant （t=0.171, P=0.865）. The mean arterial pressure of the two groups before operation was （89.8±8.4）mmHg and （90.2±8.5）mmHg,the difference was not statistically significant（t= 0.189, P=0.850）; the highest heart rate of the two groups after extubation was （85.6±8.2） times/rain and （96.2±8.5） times/rain ,the different was statistically signficant（t=5.077, P=0.000）, the highest mean arterial pressure of the two groups after extubation were （99.2±8.7） mmHg and （107.9±9.1） mmHg,the different was statistically signficant（t=3.909, P=0.000）. Conclusion The elderly patients with bispectral index monitoring during tracheal extubation during general anesthesia recovery period can maintain the bispectral index of brain electricity between 60 and 80, which can reduce the cardiovascular stimulation of patients during extubation. It provides a guarantee for the safety of the patient during the extubation period, and is of great value in clinical application.