【摘要】 目的 评价脑电双频指数（BIS）监测全身麻醉深度的准确性及实用性。 方法 2007年10月-2009年10月择期行腹腔镜胆囊切除手术的40例ASAⅠ或Ⅱ级患者随机平均分为A、B组，两组均采用丙泊酚、瑞芬太尼诱导和维持。A组以BIS值判断麻醉深度并指导调整用药，B组根据经验调整用药，使BIS值维持在50±5、MAP和HR维持在基础值±20%范围内。常规监测收缩压（SBP）、舒张压（DBP）、心率（HR）和BIS，计算用药总量，记录苏醒时间；诱导期进行改良警觉/镇静（OAA/S）评分，评价BIS对全身麻醉手术期间麻醉深度的监测和指导意义。 结果 麻醉期间，B组SBP、DBP、HR和BIS波动明显大于A组（P lt;0.05）；A组的苏醒时间（7.5±2.5） min明显短于B组（9.8±3.9） min（P lt;0.05）；拔管后，A组躁动、嗜睡、恶心、呕吐患者少于B组；A组无1例发生手术中知晓，B组1例发生手术中知晓。 结论 BIS可动态反映大脑生理功能的变化，有助于临床判断全身麻醉深度，指导麻醉用药。
【Abstract】 Objective To evaluate the accuracy and practicality of bispectral index (BIS) used in patients undergoing general anesthesia. Methods Forty patients of ASA class Ⅰ or Ⅱ were randomly divided into group A and B,20 patients in each group. Anesthetic depth was judged and anesthetics was administered by BIS monitoring (being kept in 50±5) in group A or based on the experience of anesthetist in group B. After anesthesia induction, target propofol and remifentanil concentrations were adjusted to maintain the MAP, HR within the range of ±20% of preinduction values. Systolic pressure (SBP), distolic pressure (DBP), HR, SpO2 and BIS were monitored. Awake time and anesthetic consumption were recorded. Results The changes of SBP, DBP, HR and BIS were less in group A than those in group B (P lt;0.05).Awake time was shorter in group A than that in group B and restlessness drowsiness, nausea and vomitting after extubation were less in group A than those in group B. No awareness patient during operation was seen in group A, but one patient suffered from awareness in group B. Conclusion BIS monitoring can dynamicly reflect cerebral physilological function during general anesthesia and is helpful in judging anesthesia depth and directing the administration of anesthetics.
Citation： ZHUANG Shaohui,ZENG Zhaodong,CHENG Minghua,ZHAO Guodong. Clinical Assessment of Bispectral Index on General Anesthesia. West China Medical Journal, 2010, 25(10): 1846-1848. doi: Copy