听觉诱发电位指数用于诱导插管期间麻醉深度监测的临床评价

An evaluation of anaesthesia depth monitoring with auditory evoked potential index during induction and tracheal intubation

目的 观察听觉诱发电位指数在全麻诱导插管期间的变化 ,评价其用于临床麻醉深度监测的有效性。方法 ASAⅠ～Ⅱ级 ,全麻下行择期手术的病人 4 0例。依次给予咪唑安定 0 0 6mg/kg、芬太尼 4 μg/kg、丙泊酚 0 5mg/kg、维库溴铵 0 1mg/kg诱导后 ,行气管插管。观察诱导前、气管插管前、插管时及插管后 1～ 5分钟等 8个时点的AEPI、BIS、HRV、SEF及MAP、HR和RPP的变化。结果 诱导后各观察指标较诱导前的基础值均有所降低 ,插管后BIS、HRV、SEF等指标均在 5分钟内回复至插管前水平 ,AEP在第 3分钟即可回复至插管前水平 ,插管前后几项观察指标变化趋势相一致。结论 AEPI、BIS、HRV、SEF均能有效反映插管的应激反应。AEPI较其他几项指标更为迅速灵敏 。

Objective To observe the changes of auditory evoked potentials index(AEPI)during induction and tracheal intubation and evaluate its effectiveness on anaesthesia depth monitoring.Methods Forty ASA Ⅰ Ⅱ patients were undergoing elective surgery under general anaesthesia.Intubation was performed following induction with midazolam 0 06mg/kg,fentanyl 4μg/kg,propofol 0 5mg/kg and vecuronium 0 1mg/kg.The changes of AEPI,BIS,HRV,SEF,MAP,HR and RPP were recorded preinduction,preintubation,during intubation and 1～5min after intubation.Results All parameters after induction were decreased compared with those preinduction.After tracheal intubation,BIS,SEF and HRV returned to the values of preintubation within five minutes,so did the AEPI at the third minute.The tendency of changes was identical before and after intubation.Conclusion All parameters mentioned above can reflect the stimulus of endotracheal intubation,among which,AEPI as an effective parameter for the monitoring of anesthesia depth is more sensitive. [