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BIS、AAI指导老年患者硬膜外阻滞复合吸入全麻麻醉镇静深度调控的临床研究
Using BIS and AAI Monitoring in elder patients under Inhalation Anaesthesia Combined with Epidural Block during the Maintenance of Anesthesia
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DOI:
作者:
孙卓真,葛圣金,李敏,薛张纲
SUN Zhuozhen,GE Shengjin,LI Min, Xue Zhanggang
作者单位:
复旦大学附属中山医院
Zhongshan Hospital,Fudan University
关键词:
脑电双频指数;听觉诱发电位指数;麻醉深度;老年人;硬膜外阻滞
Bispectral index; Auditory evoked potentials index ;Depth of anesthesia; Elder; Epidural block
摘要:
目的 探讨脑电双频指数(bispectral index,BIS)和中潜伏期听觉诱发电位指数(auditory evoked potentials index, AAI)指导老年患者硬膜外阻滞复合七氟醚吸入全麻麻醉维持期镇静深度调控的有效性。方法 选择45例65~75岁、ASA I~II级,择期在硬膜外阻滞复合全身麻醉下行腹部手术的患者,随机分为三组,分别使用AAI(A组)、BIS(B组)或根据临床医师经验(C组)来调节吸入全麻维持期的七氟醚吸入浓度。A组患者AAI维持在15±5,B组BIS维持在50±10。统计分析三组患者麻醉维持期单位时间七氟醚用量及苏醒时间,术中高血压、低血压的发生例次及有无术中知晓发生。结果 三组患者麻醉维持期单位时间七氟醚用量及苏醒时间比较差异无统计学意义(P>0.05)。三组低血压的发生率分别为26.7%、13.3%、20%,组间比较差异无统计学(P>0.05)。所有患者术中均未发生高血压和术中知晓。结论 使用AAI或BIS监测老年患者硬膜外阻滞复合七氟醚吸入麻醉的麻醉深度有效,但不能减少单位时间七氟醚的用量,不能缩短苏醒时间。
Objectives To assess the performance of bispectral index (BIS) and rapidly extracted auditory evoked potentials index (AAI) monitoring the depth of sedation in elder patients under inhalation anesthesia of sevoflurane combined with epidural block during the maintenance of anesthesia. Methods Forty-five, ASA I~ II patients aged 65-75 undergoing elective abdominal surgery under inhalation anesthesia of sevoflurane combined with epidural block,were randomized into three groups. In group A, AAI was regulated between 10 and 20. In group B, BIS was regulated between 40 and 60. And in group C the sevoflurane concentration of the vaporizer was changed under the direction of anesthesiologist’s experience. The consumption of sevoflurane during the maintenance of anesthesia , the time of emergence from anesthesia were recorded. The occurrence of hypertension, hypotension and awareness during anesthesia were compared among three groups. Results There were no significant difference in consumption of sevoflurane per 30 minutes and the time of emergence from anesthesia among three groups(P>0.05).No patient had hypertension and awareness during anesthesia, and the occurrence of the hypotension were 26.7%,13.3%,20.0% (P>0.05) respectively. Conclusion Using BIS or AAI monitoring did not result in a reduction of the consumption of sevoflurane and the time of emergence from anesthesia in elder patient under inhalation anesthesia of sevoflurance combined with epidural block.
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