麻醉深度指数指导全麻手术麻药用量的临床观察

目的观察全麻手术期间麻醉深度指数（CSI）的变化，评价其在指导麻醉维持用药方面的价值。方法将ASAⅠ-Ⅱ级患者40例，随机分为A、B两组。A组根据CSI值来调整丙泊酚用药；B组凭借麻醉医生经验调整丙泊酚用药。记录患者入室10min（To）、插管前1 min（T1）、插管后3min（T2）、切皮时（T3）、手术刺激最强时（L）、拔管前（T5）、出手术室（T6）等各时点的CSI监测值，计算全麻药的用量。诱导期每20s记录一次CSI值并进行OAA／S评分。结果A组CSI值在各时点波动较B组小；A组术中麻醉药追加量少于B组，差异有统计学意义；诱导期CSI与OAA／S评分具有显著的等级相关性。结论采用麻醉深度指数（CSI）监测全麻手术，指导麻醉医师调控用药，提高了全身麻醉的安全和质量。

Clinical Observation on Maintenance Medication of Anesthesia Guided by Cerebral State Index during General Anesthesia

Objective To evaluate the value of cerebral state index（CSI） on guiding the maintenance of anesthesia medication during general anesthesia. Methods Forty ASA class Ⅰ to Ⅱ patients were randomly divided into two groups： Group A （n = 20） and group B （n = 20）. In group A, medication of Propofol was adjusted according to CSI. In. group B, medication of Propofnl was judged according to its experiences. CSI was detected at the time point of ten minutes after the patients getting into the operating room（T0 ）,one minute before intubations（ T1 ）,three minutes after intubations （T2 ）, incision（ T3 ）, the strongest stimulus of the operation （T4）, before extubation（ T5 ）, leaving the operating（ T6 ） respectively. CSI was recorded every 20 s and OAA/S was gra- ded during the inductive phase. Results The value of CSI changed lesser in group A than that of group B at any time point. The additional quantity of anesthetics in group A was significant lesser than group B. The rank correlation was significant seen between CSI and OAA/S score during induction period. Conclusion The maintenance medication of anesthesia guided by CSI can elevate the security and quality of general anesthesia.