摘要
目的:肌松状态下的术中知晓已引起国内外广泛关注,本研究分析脑电双频指数(BIS)监测罗库溴铵肌松状态下觉醒状态(wakefulness)恢复的可行性和可靠性。方法:选择16例ASA Ⅰ-Ⅱ级在单纯全麻下行择期手术的成年病人。使用HXD-1多功能监护仪连续监测BIS。静注丙泊酚和罗库溴铵诱导麻醉,气管插管。采用独立臂技术判定觉醒状态的恢复与消失。待觉醒状态恢复后.以10mg·kg-·h-1持续静注丙泊酚直至觉醒状态再次消失。结果:觉醒状态恢复前后各30s 内,BIS值分别为62.1±6.2和65.9±6.1。觉醒状态存在时BIS值明显大于觉醒状态消失后(P<0.001)。BIS预测觉醒状态恢复的Pk值是0.662。觉醒状态恢复概率为5%、50%和95%的BIS值分别是51、63和74。结论:BIS可以作为肌松状态下监测觉醒状态恢复的指标,但敏感性和特异性有待提高。
Objective:To assess the performance of the bispectral index (BIS) to detect the recovery of wakefulness in anesthetized and paralyzed patients. Methods: Sixteen adult patients undergoing selective surgery were anesthetized with propofol and rocuronium. Wakefulness was measured by the ability of the patient to respond to commands using the isolated forearm tech nique (IFT).After the patient responded. propofol was infused at 10 mg·kg1· h 1 until wakefulness was lost again. BIS were recorded continuously and analyzed off-line. Results:BIS showed a significant difference between the values recorded 30 s before and 30 s after the recovery of wakefulness. The prediction probability (Pk) value for BIS was 0. 662 during the transitions from unresponsiveness to wakefulness. The value of 5% ,50% and 95% predicted probability of wakefulness were 51 .63.74 for BIS. Conclusion: BIS can be used as a predictor of recovery of wakefulness for anesthetized and paralyzed patients.
出处
《中国临床医学》
北大核心
2005年第1期156-158,共3页
Chinese Journal of Clinical Medicine
