脑电双频指数监测在老年患者麻醉苏醒中的作用

目的 研究脑电双频指数（BIS）指导七氟醚吸入对老年患者麻醉苏醒的影响.方法 择期行下腹部手术的老年患者44例,ASAⅠ~Ⅱ级,随机数字表法分为BIS组（B组）和对照组（D组）,每组22例.D组由麻醉医生根据临床经验调节术中七氟醚的吸入浓度 B组术中维持BIS值在45~55,术毕前10min维持在56~70.记录麻醉诱导前、手术期间和拔管时的BIS值、七氟醚设定浓度和呼气末浓度 苏醒时间、拔管时间、OAA /S评分达到5分的时间.结果 与D组相比,B组术中七氟醚用量减少20%,手术期间的BIS升高、呼气末七氟醚浓度降低,手术结束时呼气末七氟醚浓度降低,苏醒时间、拔管时间、OAA /S评分达到5分的时间缩短.结论 BIS指导吸入七氟醚能加快老年患者腹部手术的麻醉苏醒,提高苏醒质量,并可减少术中七氟醚的用量.

Bispectral index monitoring improves early recovery of elderly patients under sevoflurane anesthesia

Objective To evaluate the application of BIS monitoring during sevoflurane anesthesia in elderly patients undergoing intra-abdominal surgery. Methods Forty-four ASA I or II patients aged over 60 undergoing intra-abdominal surgery were randomized divided into two groups with 22 cases each： BIS group and control group. In BIS group sevoflurane was titrated to keep BIS values 45-55 during operation; and the BIS value was increased to 56-70 at 10 min before the end of operation. In control group the depth of anesthesia was maintained based on the clinical experience of anesthesiologist. The BIS values and the end-tidal sevoflurane concentration before and during anesthesia and at extubation, recovery time, extubation time and the time OAA/S score to 5 were recorded and compared between the two groups. The mini-mental state examination （MMSE） was used before and at 1, 2, 12 and 24h after surgery. Results The total amount of sevoflurane consumed was 20% less, the average BIS values were higher and end-tidal sevoflurane concentration was lower in BIS group than those in control group. The time from the end of surgery to eye opening, to exbuation and OAA/S score to 5 were significantly shorter in BIS group than those in control group. The MMES score was significantly decreased at lh and 2h after surgery as compared to the baseline score in control group, while in BIS group the MMES score was only significantly decreased at lh after surgery. Conclusion Titration of Sevoflurane using BIS monitoring can reduce the dose of sevflurane, improve earlier awakening and faster recovery of cognitive function in elderly patients undergoing intra-abdominal surgery.