靶控输注与脑电双频谱指数在ICU的联合应用

目的观察ICU病人丙泊酚分步靶控输注(TCI)镇静时镇静深度和脑电双频谱指数(BIS)的变化,探讨TCI和BIS是否适合国人ICU的镇静监测。方法收集15例65～78岁的ICU危重病人,进行丙泊酚分步TCI镇静。靶浓度(Ct)由0.5μg/ml→1.0μg/ml→1.5μg/ml→2.0μg/ml,平衡15分钟后观察BIS、Ramsay评分。结果丙泊酚分步靶控输注镇静时BIS随着Ct增加而下降。BIS与Ct呈负相关,相关系数r为-0.638。Ramsay评分与BIS呈负相关,相关系数r为-0.860。Ramsay评分与Ct呈正相关,相关系数为0.643(P﹤0.01)。结论TCI和BIS联合进行镇静可以体现监测的数字化、规范化。TCI和BIS联合进行镇静的实施和监测在国人ICU中使用证实有临床意义。

Application of the Bispectral Index during a Step-by-Step TCI of Propofol in the ICU Patients

Objective The study was designed to observe the changes in bispectral index and sedation during a step-by-step TCI of propofol in the ICU patients. Meanwhile the suitation of use of TCI and BIS in the chinese ICU was also investigated. Methods Fifteen patients aged 65-78 years with mechanical ventilation in ICU were studied. Patients with severe cardiovascular disease were excluded. Anesthesia was induced with propofol administered by a TCI system. The target concentration (Ct) of propofol was increased step-by step from 0.5 μg/ml to 2.0 μg/ml in 3 steps. At each step Ct increased by 0.5 μg/ml and the interval between the two steps was about 15 minutes. The changes in BIS were recorded and Ramsay sedation scores were measured. Result Ramsay increased and BIS decreased as the target concentration (Ct) of propofol increased step-by step.There was a correlation between BIS and Ramsay, Ramsay and Ct, BIS and Ct (r = -0.889, 0.813, -0.910 respectively, P <0.01) . Conclusion In view of standardizing, digitizing monitoring of the advanced administration concept in ICU, it is confirmed that the use of TCI and BIS in ICU has clinical significance.