听觉诱发电位指数监测老年患者诱导气管插管期间麻醉深度的评价

The evaluation of anesthesia depth monitoring with auditory evoked potentials index during induction and tracheal intubation for the elderly

目的 研究听觉诱发电位指数 (AEPindex)用于老年患者诱导气管插管期间麻醉深度监测的可行性与有效性。 方法 选择听力正常拟行气管插管全麻患者 10 2例 ,观察记录诱导前 (T0 )、诱导后气管插管前 (T1 )、插管时 (T2 )及插管后 1、3、5min(T3 、T4、T5)患者AEPindex、脑电双频谱指数(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 ,观察分析 2组患者诱导插管期间各项指标变化。 结果 老年组和非老年组患者T0 期AEPindex分别为 75 6± 14 9和 79 5± 17 7(P >0 0 5) ,BIS分别为 83 9± 14 9和 87 0± 11 0 (P >0 0 5)。诱导后所有患者T0 期AEPindex和BIS分别下降到 3 0和 55以下 (T1 与T0 比较 ,P <0 0 1) ;插管应激使AEPindex、BIS、MAP、HR显著升高 ,T1～ 5时点各参数均表现为先升后降 ,但插管后 5min除AEPindex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 ,,两组变化趋势一致。

Objective To observe the changes of auditory evoked potentials index(AEP index ) dur ing induction and tracheal intubation for the elderly and evaluate its effective ness on anesthesia depth monitoring. Methods One-hundred and two patients (ASA grade I-II) without obvious auditory and p sychiatric dysfunction undergoing elective surgery under general anesthesia were enrolled in this study, and they were distributed into the elderly group (age≥ 60 years) and the young group (age<60 years) according to the patients’ age. The changes of AEP index , bispectral index (BIS), mean artery pressure (MAP ), heart rate (HR) were recorded at conscious status before induction(T 0 ), after induction(T 1 ), during intubation(T 2 ) and 1,3,5 minut es post-intubation(T 3 , T 4 , T 5 ), and then the changes of AEP index , BIS, MAP, HR at different time points in different groups were comp ared using SPSS 10 0 statistic software. Results Demographic data of all patients in two groups were compared.In the elderly and the young group, AEP index were 75 6±14 9 and 79 5±17 7(P>0 05), and BIS were 83 9±14 9 and 87 0±11 0(P>0 05)respeetively before induction, which shoued no statistic difference between two groups.AEP index and BIS of two groups after induction were decreased to below 30 a nd 55 respeetively(T 1 vs. T 0 ,P<0 01).AEP index , BIS, MAP and HR increased significantly during intubation (T 2 vs. T 1 ,P<0 01), and the higher level of BIS, MAP and HR lasted to T 5 (T 3-5 vs. T 1,P<0 01), while AEP index returned to T 1 l evel at T 5 (T 3-4 vs. T 1,P<0 01;T 5 vs. T 1,P>0 01) ) . The changing tendency of the elderly group and the young group were identical a t all time points. Conclusions AEP index can be used for the anesthesia depth monitoring for the elderly without obvious auditory dysfunction during tracheal intubation.