靶控输注联合脑电双频指数监测在脊柱侧凸矫形术患者术中唤醒中的应用

目的探讨靶控输注（target-controlled infusion,TCI）联合脑电双频指数（bispectral index,BIS）监测在脊柱侧凸矫形术患者术中唤醒的应用。方法选择行脊柱侧凸矫形术的患者20例,均行全凭静脉麻醉,同时运用TCI联合BIS监测指导用药。观察20例患者唤醒前、唤醒时的心率（HR）、血压收缩压（SBP）、舒张压（DBP）]、动脉血氧饱和度（SpO2）、BIS的变化和术后第1天询问患者对唤醒试验及手术过程的记忆等情况。结果 20例患者均能按指令抬头、睁眼,活动脚趾,足背伸、屈,能点头或摇头示意下肢麻木感。唤醒时间为2.1～3.3 min,唤醒时的HR、SBP、DBP、SpO2水平与唤醒前比较差异均无统计学意义（均P〉0.05）,BIS值与唤醒前比较差异有统计学意义（P〈0.05）。术后均未发现有脊髓损伤,术后第1天随诊患者对唤醒试验及手术过程无知晓。结论 TCI及BIS监测联合应用于脊柱侧凸矫形术患者术中唤醒,对术中唤醒时间有较好的调控性。

Application of Target Controlled Infusion Combined with Bispectral Index Monitoring in Intraoperative Wake-up during Scoliosis Correction Surgery

Objective To explore the application of target-controlled infusion（TCI） and bispectral index（BIS）monitoring in intraoperative wake-up during scoliosis correction surgery.Methods Twenty patients who required scoliosis correction surgery received total intravenous anesthesia and TCI joint BIS monitoring of the guide drug.Heart rate（HR）before and after wake-up time,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,arterial oxygen saturation（SpO2）and changes in BIS were observed,and patient＇s memories of wake-up test and surgical procedure were asked on the first day after operation.Results All patients could look up,open eyes,move toes,perform foot dorsiflexion and flexion,and nod or shake head to indicate the lower limb numbness according to instructions.Wake-up time ranged from 2.1 to 3.3 minutes.Compared with levels before wake-up,HR,SBP,DBP and SpO2 did not change significantly after wake-up（all P0.05）.However,BIS value before wake-up was obviously different from that after wake-up（P0.05）.No patients had postoperative spinal cord injury and knew wake-up test and surgical procedure on postoperative day 1.Conclusion Combined application of TCI and BIS monitoring can effectively regulate intraoperative wake-up time in patients undergoing scoliosis correction surgery.