围插管期老年患者听觉诱发电位指数和脑电双频谱指数的变化

The changes of auditory evoked potentials index and bispectral index during induction and tracheal intubation for the elderly

目的 研究诱导气管插管期间老年患者听觉诱发电位指数 (AAI)和脑电双频谱指数 (BIS)的变化。方法 听力正常拟行气管插管全麻患者 5 6例 ,观察记录诱导前 (T0 )、诱导后置入喉镜气管插管前 (T1)、插管时 (T2 )及插管后 1,3,5min(T3 ,T4,T5)患者AAI、BIS、平均动脉压 (MAP)及心率 (HR)的变化。根据患者年龄分为老年组和非老年组 ,分析两组患者围气管插管期各指标的变化。结果 两组患者术前一般状况及诱导前 (T0 )AAI,BIS ,MAP ,HR差异无显著性 (P >0 0 5 ) ,诱导后所有患者各指标较T0 均有显著降低 ,喉镜暴露声门和气管插管应激使AAI,BIS ,MAP ,HR显著升高 ,T1～ 5时点各参数表现为先升高后下降。但插管后 5min(T5)除AAI回落至插管前水平(T5与T1相比 ,P >0 0 5 )外 ,其余参数仍明显高于插管前水平 (T5与T1相比 ,P <0 0 5 )。老年组和非老年组间AAI及BIS变化无明显差异。结论 诱导气管插管期间老年患者AAI及BIS变化趋势一致 。

Objective To observe the changes of auditory evoked potentials index(AAI) and bispectral index(BIS) during induction and tracheal intubation for the elderly. Methods Fixty-two patients scheduled for elective surgery under general anesthesia were divided into the elderly group(age≥60) and the young group(ange<60) according to their age. Tracheal intubation was performed following induction with midazolam, fentanyl, propofol and vecuronium. The changes of AAI, BIS, MAP and HR were recorded at consciousness state before induction(T 0), after induction(T 1), intubation(T 2) and post-intubation 1,3,5 minutes(T 3、T 4、T 5). The changes of AAI, BIS, MAP and HR at different time point and different groups were compared. Results All parameters of both groups after induction decreased compared with that of prienduction(T 1 vs T 0, P<0.01). AAI, BIS, MAP and HR increased significantly under the intubation stress(T 2 vs T 1, P<0.05～0.01), and remained higher level of BIS, MAP and HR until T 5(T 3～5 vs T 1,P<0.05～0.01). AAI returned to T 1 level at T 5(T 3～4 vs T 1,P<0.05～0.01; T 5 vs T 1,P>05). The changing tendency of the elderly group and the young group were identical at all time points. Conclusion Both AAI and BIS can be used for monitoring anesthesia depth in the elderly during induction and tracheal intubation.