熵指数监测在骨科手术静吸复合麻醉中的应用

目的：探讨熵指数在全麻期间意识水平监测的有效性和特点。方法：全部为ASAⅠ-Ⅲ级骨科手术病人48例。麻醉诱导：丙泊酚2 mg/kg,舒芬太尼0.5μg/kg,顺苯磺阿曲库铵0.15 mg/kg。麻醉维持：七氟醚吸入,维持在1.0 MAC,麻醉全过程同时监测熵指数（Entropy）,根据脑电监测追加舒芬太尼及丙泊酚。观察监测麻醉过程的变化：基础值、意识消失时、气管插管前、插管即刻和气管插管后1、3、5 min,呼之睁眼的Entropy值（分别记录为状态熵SE、反应熵RE）,结果：诱导后RE、SE值均显著下降（P〈0.01）;术毕RE、SE值逐渐回升,病人呼之睁眼时RE、SE值均接近基础值,RE值回升最快。结论：熵指数作为全麻期间意识水平监测敏感、有效,反应熵监测反应快。

Application of Entropy Monitoring During General Anaesthesia of Orthopedics Patient

Objective： To evaluate the predictive effect of entropy as a measure of anesthesia depth monitoring during general anesthesia. Methods： 48 consenting ASA physical status Ⅰ and Ⅲ patients scheduled for general anesthesia were evaluated. Anesthesia was induced with propofol 2 mg/kg, surfentanyl 0.5 μg/kg and atracuri- um 0.15 mg/kg. Sevoflurane At the time - point of baseline, loss of consciousness, before, immediately, 1 min, 3 rain, 5 rain after intubation and the response to verbal commands, the values of RE, SE, BIS, HR, MAP and SpO2 were recorded. Results：The RE and SE values decreased progressively from preinduction. Compared to the values of before intubation, RE, SE of immediately at intubation were significantly increased, especially the RE value, the response to verbal commands the RE and SE values closed to the baseline. Conclusion： Entropy can reflect promptly the consciousness during general anaesthesia , especially the RE value.