Objective To investigate change of bispectral index(BIS) and hemodynamic index during induction and orotracheal intubation of sevoflurane anesthesia. Methods This study was a prospective before-after study in the same patients. A total of 30 ASA physical status I and II adult patients without airway abnormalities were enrolled to receive inhalation induction of anesthesia with 8% sevoflurane. Mean arterial pressure(MAP),heart rate(HR) and BIS were recorded before anesthesia(T1),when patients loss of consciousness(T2), before intubation (T3),at 1 min(T4) and 3 min(T5) after intubation. Results BIS at T1-T5 were 96.8±1.7,70.4±8.8,39.2±8.4,43.6±12.9 and 41.6±9.3 respectively, the measurements at T2-T5 were all markedly lower than at T1(Plt;0.05). HR at T3-T5 were all markedly higher than at T1(Plt;0.05). MAP at T2 and T3 were markedly lower than at T1, but at T4 was higher than at T1(Plt;0.05), and recovered to the level at T1 at T5(Pgt;0.05).BIS,HR and MAP at T4 were all significantly higher than T3(Plt;0.05). Conclusion Anesthesia induction with sevoflurane and small dose of succinylchoiline we used can provide adequate depth of general anesthesia,but can not prevent cardiovascular adverse reactions to intubation.
目的：本研究旨在比较一种新的脑电参数-脑电非线性指数（ENI）与BIS在丙泊酚靶控输注时预测镇静深度的能力。方法:选择30例18～60岁，ASA Ⅰ～Ⅱ级，拟行择期普外科手术患者。每一患者同时监测ENI和BIS。麻醉诱导给予丙泊酚靶控输注，直至患者意识消失后给予芬太尼和罗库溴铵行气管插管。麻醉诱导过程中每30秒进行一次镇静评分（采用改良OAA/S评分），并记录ENI和BIS值以及平均动脉压（MAP）和心率（HR）。结果:ENI和BIS与镇静评分的相关性比MAP和HR高（r=0.90、0.93 vs r=0.77、0.27）。镇静过程（改良OAA/S评分）中ENI和BIS有很好的相关性(R2=0.828)。ENI和BIS预测镇静深度的能力优于MAP和HR。结论：ENI可提供与BIS相似的反映镇静深度的信息，能准确预测不同的镇静深度。
目的：探讨脑电双频指数(BIS)监测在机械通气患者镇静深度评价中的价值。方法：选取15例机械通气患者，静脉注射咪唑安定达到SAS评分3～4分，持续或间断给药维持镇静深度，记录患者每2小时的SAS镇静分级评分及BIS，观察24小时。比较SAS评分与BIS值的相关性。计算BIS的敏感度和特异度，根据ROC曲线和BIS评价镇静深度的敏感度和特异度，寻找最适BIS值。结果:随镇静深度的加深，BIS明显降低，BIS与SAS评分呈正相关(r=0.662，P＜0.05)；SAS评分3～4分(镇静适度)时对应的BIS临界值为69.5～79。结论：BIS监测与SAS评分之间具有良好的相关性，能同步客观地监测机械通气患者的镇静深度，具有一定的临床诊断价值。
目的 研究脑电双频指数（BIS）在小儿麻醉中的应用，为BIS在小儿临床麻醉上的广泛应用及提高小儿麻醉的安全性提供依据。 方法 2011年1月－3月拟行腹部外科手术的患儿60例，男39例，女21例；年龄1～4岁，美国麻醉医师协会分级Ⅰ～Ⅱ级，随机分为两组，每组各30例。S组：七氟醚、瑞芬太尼和维库溴铵维持麻醉；P组：丙泊酚、瑞芬太尼和维库溴铵维持麻醉。采用BIS监测麻醉深度，将BIS控制在50 ± 5，记录麻醉诱导前到手术探查期间不同时点的血流动力学参数及苏醒、拔管时间。 结果 手术过程中P组血压及心率明显低于麻醉前水平（P＜0.05）。S组苏醒迅速、完全，苏醒时间与P组比较差异有统计学意义（P＜0.05）。S组的血流动力学稳定性优于P组，苏醒时间、拔管时间相对较短。麻醉诱导前两组的BIS值均为97 ± 1，意识消失时的BIS值为71 ± 2。BIS值为50 ± 5时，结果显示手术过程中（T4、T5、T6、T7）两组的心率、血压都很平稳。 结论 BIS作为小儿麻醉镇静深度的监测指标有临床意义。
目的 评价舒芬太尼复合艾司洛尔对腹腔镜胆囊切除术二氧化碳气腹期间心血管反应和脑电双频指数（BIS）的影响。 方法 2010年1月－2011年12月间，选择美国麻醉医师协会分级Ⅰ～Ⅱ级择期腹腔镜胆囊切除术患者90例，随机分为芬太尼组（A组）、舒芬太尼组(B组）和舒芬太尼+艾司洛尔组（C组）。A组用芬太尼4 μg/kg，B、C组用舒芬太尼0.6 μg/kg麻醉诱导后气管插管，机械通气；C组在气腹前加用艾司洛尔。3组均常规静脉注射咪达唑仑0.1 mg/kg、丙泊酚2 mg/kg和维库溴铵0.1 mg/kg。分别记录各组在气腹前（T1）、气腹30 s（T2）、气腹5 min（T3）、气腹15 min（T4）时的收缩压、舒张压、平均动脉压、心率、血氧饱和度和BIS值。 结果 T1时C组收缩压、舒张压、心率、BIS值最低，各组间差异无统计学意义（P＞0.05）；T2、T3、T4时A组收缩压、舒张压、心率、BIS明显增加，B组有所上升，ⅢC组各时段变化不明显。A组与B组、B组与C组间差异有统计学意义（P＜0.05）。 结论 舒芬太尼复合艾司洛尔能更好地预防腹腔镜胆囊切除术二氧化碳气腹期间心血管反应和抑制BIS的增加。
【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（Plt;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（Plt;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 (Plt;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.
目的：研究影响机械通气患者BIS值的相关因素。方法：42例机械通气患者，BIS模块连续监测镇静深度48小时，记录患者镇静前后、每隔16小时的呼吸循环指标，BIS值、SAS评分，建立混合线形统计模型，评价BIS监测的影响因素。结果：患者的血压、心率、呼吸频率、PaO2、SPO2 、FiO2等均对BIS值无影响，仅有PaCO2和SAS评分与BIS相关(P＜0.05)。结论：BIS模块监测机械通气患者镇静深度，BIS值的变化与患者PaCO2及SAS评分有关。
目的:探讨ICU机械通气患者使用脑电双频指数(BIS)指导镇静的临床作用。方法:采用前瞻性完全随机对照研究。将53例患者分为2组,分别用BIS和主观评分进行镇静监测48h,设定SAS评分3~4分为镇静目标,评估临床指标如机械通气时间、ICU住院日、给药率和肢体制动率的组间差异,评价BIS监测在机械通气患者的临床应用价值。结果: 两组患者均达镇静目标,BIS监测较常规镇静监测组机械通气时间(1733±1577d vs. 3983±5633d)和ICU住院日(2160±2045d vs. 4167±5581d)缩短,肢体制动率下降(4070%vs.7690%)(Plt;005),但给药率无统计学意义(Pgt;005)。结论:BIS监测可以缩短ICU患者的机械通气时间和ＧICU住院日,减少肢体制动率。
目的:观察七氟醚靶控用于低流量吸入麻醉维持的临床规律及血流动力学变化,寻求靶控下的药物量化指标。方法:选择60例20～60岁手术患者,随机分2组每组30例:P组(丙泊酚)常规实施全凭静脉TCI靶控麻醉;S组(七氟醚),实施低流量七氟醚靶控吸入麻醉(BIS值40)。分别记录诱导前(T1),插管后5(T2)、15(T3)、30(T4)45(T5)、60(T6)、90(T7)、120(T8)min时的、MBP、HR、;Sev组患者加记各个时点的七氟醚IT、ET的MAC值。结果:T2点两组均比T1 降低(Plt;0.05),S 组高于P组(Plt;0.05),两组比较T3至T7无显著性差异(Pgt;0.05);S 组T3 至T7 各点ET值无统计学差异,ET%:2.46,约1.4 MAC。结论:(1)七氟醚诱导较静脉麻醉诱导患者血流动力学稳定,(2)低流量七氟醚靶控吸入麻醉维持平稳,调控简便,效果良好。
Objective To assess the correlation between bispectral index (BIS) and richmond agitation sedation scale (RASS) and sedation-agitation scale (SAS) through the spearman correlation coefficient by systematic review. Methods Databases including PubMed, EMbase, Web of Science, The Cochrane Library (Issue 7, 2016), CNKI, VIP, WanFang Data and CBM were searched from inception to July 2016 to collect literature on the correlation between BIS and RASS and SAS. The studies were screened according to the inclusion and exclusion criteria. After extracting data and assessing the quality of the included studies, meta-analysis was conducted using Comprehensive Meta Analysis 3.0 software. Results A total of 12 studies involving 397 patients were included. BIS was positively correlated with RASS score and SAS, and the summary correlation coefficient was 0.742 with 95% CI 0.678 to 0.795 and 0.605 with 95% CI 0.517 to 0.681, respectively. Conclusion BIS has a good correlation with RASS and SAS, which will provide more options for assessing sedation of patients with mechanical ventilation in ICU.