脑电双频指数指导依托咪酯麻醉在逆行胰胆管造影术中的应用

目的 探讨脑电双频指数(bispectral index,BIS)指导依托咪酯麻醉在逆行胰胆管造影术(ERCP)中的应用.方法 选择择期行ERCP的患者40例,随机分为BIS组和对照组,每组20例.BIS组:麻醉医生在BIS监测下指导依托咪酯静脉维持麻醉,术中BIS维持在65～70.对照组:麻醉医生根据临床经验调整泵入依托咪酯剂量.手术由同一操作熟练的医生进行.记录两组诱导前、麻醉期间、手术结束及清醒后的BIS值、依托咪酯总量、清醒时间、手术时间和麻醉恢复时间.结果 BIS组麻醉期间BIS值高于对照组,麻醉清醒时间、麻醉恢复时间均短于对照组,依托咪酯总量少于对照组,差异均有统计学意义(P＜0.05).结论 BIS指导依托咪酯用于ERCP麻醉安全有效,具有麻醉恢复快,麻醉药用量少等优点.

Application of Bispectral Index to Direct Etomidate Anesthesia in Patients Undergoing ERCP

Objective To investigate feasibility of Etomidate guided by bispectral index（BIS） medicated to anesthetize patients undergoing ERCP.Methods 40 patients undergoing ERCP were chosen and randomly divided into two groups： control group and BIS group,20 patients of each.BIS group： during the operation,anesthesia was guided by BIS and the value of BIS was kept within the range of 65-70.Control group： all the 20 patients were anesthetized by the same doctor and the concentration of Etomidate was adjusted according to his clinical experience during the operation of ERCP.Operations of all the 40 patients were accomplished by the same doctor.Value of BIS before the anesthesia and during the process of anesthesia and the dosage of Etomidate medicated during the operation,awake time of anesthersia,and recovery time were recorded.Results Compared with that of the control group,the value of BIS of BIS group was lower,awake time and recovery time of patients of the BIS group were shorter,the dosage of Etomidate of the BIS group was smaller than that of the control group,and significant difference was found（P0.05）.Conclusion BIS used to guide Etomidate medicated in ERCP is safe and efficient and can reduce the dosage of Etomidate needed in ERCP and shorten the recovery time from anesthesia.