脑电双频指数监测在丙泊酚宫腔镜手术麻醉中的临床观察

目的：探讨脑电双频指数（BIS）监测在丙泊酚宫腔镜手术麻醉中的作用。方法：选择60例择期在丙泊酚一芬太尼静脉麻醉下行宫腔镜手术的门诊或住院病人，用随机数字表法分为BIS反馈组（A组）和对照组（B组），每组30例。观察记录注药前（T0）、意识消失时（T1）、扩张宫颈时（T2）、术毕清醒时（L）各时点的平均动脉压（MAP）、心率（HR）、血氧饱和度（SPO2）和BIS值变化情况，并记录丙泊酚使用总量、患者苏醒时间、手术时间、追加丙泊酚例数及不良反应。结果：与注药前（T0）相比，两组患者在T1、T2时点MAP值均显著下降（P〈0．05），但A组MAP下降幅度小于B组（P〈0．05），两组患者在T1、T2时点BIS值均显著下降（P〈0．01），但B组下降幅度比A组大（P〈0．05）。A组丙泊酚用量、苏醒时间均明显小于B组（P〈0．05），A组不良反应明显小于B组（P〈0．01）。结论：脑电双频指数（BIS）反馈调控丙泊酚用于宫腔镜手术麻醉．可在保证适当麻醉深度的情况下有效减小丙泊酚用量，缩短患者苏醒时间。明显提高宫腔镜手术麻醉质量。

Clinical Observation of Bispectral Index Monitor to Hysteroscopic Surgery with Propofol Anesthesia

Objective： To investigate the action of Bispectral Index IBIS） monitor to hysteroscopic surgery with propofol anesthesia. Method： 60 out- and in-patients undergone hysteroscopic surgery with propofol-fentanyl vein anesthesia were separated, according to the random digital watch law, into BIS feed- back group （group A） and control group （ gqroup B）, 30 patients each group while observe changes of MAP, HR, SPO2 and BIS at To, T1 , T2 and T3 as well as total propofol dose, the patients＇ wake time, operation time, number of patients appended propofol and adverse reactions were recorded. Result： MAP value in both groups at T1 ＆ T2 to To significantly drops down where the descending rate in group A is lower than group B （ P〈0. 05 ） ; BIS value in both groups at T1 ＆ T2 is significantly drops down （ P〈0. O1 ） where the de- scending rate in group B was higher than that in group A （ P〈0.05 ）. Wake time and ~,La｜ propofol dose in group A was significantly lower than that in group B （ P〈0.05 ） and adverse reaction in group A is also signif- icantly lower than group B （ P〈0.01 ）. Conclusion： Bispeetral Index （BIS） feedback control in hysteroscopie surgery with propofol anesthesia can effectively reduce the propofol dose and wake time under the condition that the proper depth of anesthesia is ensured and obviously improve the quality of hysteroseopic surgery.