脑干听觉诱发电位(BAEP)用于监测小儿全麻深度及觉醒的研究

目的：研究应用脑于听觉诱发电位（BAEP）作为监测小儿全麻深度及觉醒的客观指标，方法：选择非神经外科无听力障碍的择期手术患儿45例，ASAⅠ-Ⅱ级，分别施行异丙酚，芬太尼静脉麻醉及异氰醚入全身麻醉，观察各波潜伏期（PL）和波间期（IPL）随时间推移及麻醉剂量之间的关系，结果：（1）异丙酚静脉麻醉和异氟醚吸入麻醉与剂量呈良好的正相关，即随着麻醉药的浓度（或剂量）的增高，BAEP各波PL及IPL逐渐延长，反之逐渐缩短。（2）I波的潜伏期特性对于控制麻醉深度为重要。（3）V波监测麻醉具有最佳的稳定性及相关性。（4）停用麻醉药一段时间或患儿基本清醒时，BAEP各波PL和IPL有的仍高于正常值。这是滞后（延迟）反应。（5）BAEP对芬太尼术中的觉醒监测不太敏感，即相关性较差，结论：BAEP各波的潜伏期及峰间期变化，可判断小儿全身麻醉深度，在一定程度上中作为判断觉醒的参考，但应考虑有延迟反应的可能。

Clinical Study on Brainstem Auditory Evoked Potential in Monitoring Anesthesia Depth and Awaken in Children

Objective: To study the objective guide of brainstem auditory evoked potential (BAEP) in monitoring the general anesthesia depth and awaken in children. Methods: Forty-five children with ASA graded I~ II and normal audition received the anesthesia of propofol, fentanyl, and isoflurane respectively, and the changes of PL and IPL and anesthesia dosage were studied. Results: (1) There was a significant positive correlation between propofol and isoflurane and their dosage. (2)PL of wave I was important to anesthesia degree. (3) It was wave V with the best stability and correlation to monitor anesthesia degree. (4) PL and IPL of some BAEP waves were still higher than normal after a period of anesthesia or patients almost awaken. (5) BAEP was not sensible for fentanyl anesthesia in intraooperative monitoring awaken. Conclusion: The change of PL and IPL can be used to determine the general anesthesia degree and awaken. Detention reaction should be consulted.