脑电双频指数用于门诊无痛内镜检查的临床研究

目的　观察脑电双频指数 (BIS)监测对门诊无痛内镜检查病人麻醉过程及恢复的意义。方法　 12 0例择期在丙泊酚 芬太尼静脉麻醉下行胃镜检查的门诊病人 ,随机分为BIS监测组 (A组 )与常规监测组 (B组 ) ,每组 6 0例。静脉给予芬太尼 1μg/kg、丙泊酚 0 5mg/kg负荷量后 ,丙泊酚的维持量A组根据BIS值 (4 5～ 6 0 )调节 ,B组仅根据临床体征调节。记录丙泊酚用量、术中反应、胃镜检查时间及留观时间等。结果　两组间一般资料及麻醉前MAP、HR、SpO2 、BIS均无显著性差异(P >0 0 5 )。丙泊酚用量A组明显少于B组 ,留观时间A组显著短于B组 (P <0 0 1)。MAP在麻醉诱导入睡后和插镜时两组均有下降 ,但A组降幅低于B组 (P <0 0 1)。不良反应发生率A组明显少于B组 (P <0 0 1)。结论　BIS监测用于门诊麻醉对预防麻醉药用量不足或逾量 ,减轻血液动力学改变 ,避免术中肢动与知晓有重要意义 ,有利于提高麻醉安全 ,减少并发症。

A clinical study on bispectral index monitoring used in out patients undergoing gastroduodenoscopy

Objective To evaluate the usefulness of BIS monitoring in out patients undergoing gastroduodenoscopy under propofol anesthesia.Methods One hundred twenty patients undergoing selective gastroduodenoscopy under propofol-fentanil anesthetsia were randomly assigned to regular monitor plus BIS monitoring (group A,n=60)or regular clinical monitor (group B, n=60). In group A, propofol infusions were adjusted to achieve a target BIS of 45-60. In group B, propofol dose adjustments were made based only on standard clinical signs. Drug use, intraoperative responses, and recovery parameters were recorded.Results Both groups were comparable with respect to demographic data, initial parameters, and duration of gastroduodenoscopy. The amount of propofol used was significantly less in group A than that in group B, so did the decrease MAP at T 1 and T 2.Conclusion Titrating propofol with BIS monitoring during intravenous anesthesia for day case surgery may prevent propofol under or over dose, keep hemodynamics stable and make recovery quicker.