Background: Hypnosis monitoring has been shown to reduce the incidence of awareness. A-line ARX-IndexTM (AAI) derived from auditory evoked potentials (AEP) represents as a numerical variable depth of anaesthesia. Obje...Background: Hypnosis monitoring has been shown to reduce the incidence of awareness. A-line ARX-IndexTM (AAI) derived from auditory evoked potentials (AEP) represents as a numerical variable depth of anaesthesia. Objectives: To study the efficacy of AEP as an indicator of anaesthetic depth and monitor intraoperative awareness in neurosurgical patients by using the AAI scale. Design: Prospective cohort study is used. Setting: The study is in Neurosurgical centre of Tertiary care hospital. Participants: Neurosurgical patients requiring general anaesthesia with duration of surgery between 90 - 150 minutes were enrolled for the study. Intervention: Patients in Group 1 (control) were monitored by conventional methods. Patients in Group 2 (study) underwent intraoperative monitoring by using the AEP monitor. Primary outcome: To study the efficacy of AEP monitoring and AAI index for monitoring the depth of anaesthesia and reducing the incidence of awareness. Results: There was no significant difference in the intraoperative haemodynamic responses measured between the two study groups (p > 0.5). There was no significant difference in the identification of intraoperative awareness by using conventional parameters between the two groups (p > 0.5). There was also a significantly faster time to recovery for patients in Group 2 (p < 0.05). Conclusion: Hypnosis monitoring using AEP monitor/AAI in neurosurgical patients under general anaesthesia did not show any significant difference in haemodynamic response and intraoperative awareness but had significant lower consumption of volatile anaesthetic with cost sparing effect and a faster recovery time as compared to conventional monitoring.展开更多
文摘Background: Hypnosis monitoring has been shown to reduce the incidence of awareness. A-line ARX-IndexTM (AAI) derived from auditory evoked potentials (AEP) represents as a numerical variable depth of anaesthesia. Objectives: To study the efficacy of AEP as an indicator of anaesthetic depth and monitor intraoperative awareness in neurosurgical patients by using the AAI scale. Design: Prospective cohort study is used. Setting: The study is in Neurosurgical centre of Tertiary care hospital. Participants: Neurosurgical patients requiring general anaesthesia with duration of surgery between 90 - 150 minutes were enrolled for the study. Intervention: Patients in Group 1 (control) were monitored by conventional methods. Patients in Group 2 (study) underwent intraoperative monitoring by using the AEP monitor. Primary outcome: To study the efficacy of AEP monitoring and AAI index for monitoring the depth of anaesthesia and reducing the incidence of awareness. Results: There was no significant difference in the intraoperative haemodynamic responses measured between the two study groups (p > 0.5). There was no significant difference in the identification of intraoperative awareness by using conventional parameters between the two groups (p > 0.5). There was also a significantly faster time to recovery for patients in Group 2 (p < 0.05). Conclusion: Hypnosis monitoring using AEP monitor/AAI in neurosurgical patients under general anaesthesia did not show any significant difference in haemodynamic response and intraoperative awareness but had significant lower consumption of volatile anaesthetic with cost sparing effect and a faster recovery time as compared to conventional monitoring.
文摘目的探讨使用听觉诱发电位指数（A-line ARX-index，AAI）、BIS监测麻醉深度对老年患者全身麻醉下行全膝关节置换术术中麻醉药用量及术后恢复的影响。方法择期全身麻醉下行全膝关节置换术的老年患者60例，年龄65。75岁，体重45-85kg，ASA分级Ⅰ、Ⅱ级，采用随机数字表法将患者分为3组（每组20例）：使用AAI监测麻醉深度组（AAI组）、使用BIS监测麻醉深度组（BIS组）和5年以上经验麻醉医师调控麻醉深度组（CON组）。于术前1d和术后1、3、5、7d行简明精神状态量表（mini-mental state examination, MMSE ）评分，以此评估患者认知功能；记录3组患者的全身麻醉药物用量，术毕时患者的苏醒时间、拔管时间、警觉镇静（observer assessment of sedation, OAA/S）评分和VAS评分。结果AAI组和BIS组的丙泊酚用量[（450±19）、（500±18）mg]及瑞芬太尼用量[（0．78±0．07）、（0．80±0．08）mg]比CON组[丙泊酚（810±17）mg、瑞芬太尼（1．26±0．07）mg]少（P〈0．05），AAI组的丙泊酚用量比BIS组更少，差异有统计学意义（P〈0．05）；术毕AAI组和BIS组的苏醒时间[（5．4±1．5）、（10．2±1.3）min]和拔管时间[（7．3±1．6）、（14．5±1．5）min]比CON组[苏醒时间（15．3±1．8）min、拔管时间（18．2±1．7）min]短（P〈0．05），与CON组相比，AAI组和BIS组OAA／S评分高[AAI组（4．45±0．35）分、BIS组（3．74±0．43）分、CON组（2．85±0．24）分]（P〈0．05）；3组患者VAS评分[AAI组（2．0±0.6）分、BIS组（2．1±0．5）分、CON组（2．3±0．7）分]差异无统计学意义（P〉0．05）；3组术前1d，术后1、3、5、7d时MMSE评分比较，差异无统计学意义（P〉0.05）。结论应用麻醉深度监测可以节俭麻醉药用量，缩短苏醒和拔管时间，但是对MMSE评分没有明显影响。
