Clinical Assessment of Bispectral Index on General Anesthesia_West China Medical Journal

Authors：

ZHUANG Shaohui ¹ , ZENG Zhaodong ¹ , CHENG Minghua ¹ , ZHAO Guodong ²

1. Deparment of Anesthesiology, First Affiliated Hospital,Shantou Medical University, Shantou, Guangdong 515041, P.R.China; 2. Deparment of Anesthesiology, Guangdong People’s Hospital, Guangzhou, Guangdong 510081, P.R.China;

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Keywords：

腦電雙頻指數; 全身麻醉; 監測

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【摘要】目的 評價腦電雙頻指數（BIS）監測全身麻醉深度的準確性及實用性。方法 2007年10月-2009年10月擇期行腹腔鏡膽囊切除手術的40例ASAⅠ或Ⅱ級患者隨機平均分為A、B組，兩組均采用丙泊酚、瑞芬太尼誘導和維持。A組以BIS值判斷麻醉深度并指導調整用藥，B組根據經驗調整用藥，使BIS值維持在50±5、MAP和HR維持在基礎值±20%范圍內。常規監測收縮壓（SBP）、舒張壓（DBP）、心率（HR）和BIS，計算用藥總量，記錄蘇醒時間；誘導期進行改良警覺/鎮靜（OAA/S）評分，評價BIS對全身麻醉手術期間麻醉深度的監測和指導意義。結果麻醉期間，B組SBP、DBP、HR和BIS波動明顯大于A組（P lt;0.05）；A組的蘇醒時間（7.5±2.5） min明顯短于B組（9.8±3.9） min（P lt;0.05）；拔管后，A組躁動、嗜睡、惡心、嘔吐患者少于B組；A組無1例發生手術中知曉，B組1例發生手術中知曉。結論 BIS可動態反映大腦生理功能的變化，有助于臨床判斷全身麻醉深度，指導麻醉用藥。
【Abstract】 Objective To evaluate the accuracy and practicality of bispectral index (BIS) used in patients undergoing general anesthesia. Methods Forty patients of ASA class Ⅰ or Ⅱ were randomly divided into group A and B,20 patients in each group. Anesthetic depth was judged and anesthetics was administered by BIS monitoring (being kept in 50±5) in group A or based on the experience of anesthetist in group B. After anesthesia induction, target propofol and remifentanil concentrations were adjusted to maintain the MAP, HR within the range of ±20% of preinduction values. Systolic pressure (SBP), distolic pressure (DBP), HR, SpO2 and BIS were monitored. Awake time and anesthetic consumption were recorded. Results The changes of SBP, DBP, HR and BIS were less in group A than those in group B (P lt;0.05).Awake time was shorter in group A than that in group B and restlessness drowsiness, nausea and vomitting after extubation were less in group A than those in group B. No awareness patient during operation was seen in group A, but one patient suffered from awareness in group B. Conclusion BIS monitoring can dynamicly reflect cerebral physilological function during general anesthesia and is helpful in judging anesthesia depth and directing the administration of anesthetics.

Citation： ZHUANG Shaohui,ZENG Zhaodong,CHENG Minghua,ZHAO Guodong. Clinical Assessment of Bispectral Index on General Anesthesia. West China Medical Journal, 2010, 25(10): 1846-1848. doi: Copy

1.	Kearse LA, Rosow C, Zaslavsky A, et al. Bispectral analysis of electroencephalogram predicts conscious processing of information during propofol sedation and hypnosis[J]. Anesthesiology, 1998, 88(1): 25-34.
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6.	Schmidt GN, Bischoff P, Standl T, et al. Comparative evaluation of the Datex-Ohmeda S/5 Entropy Module and the Bispectral Index monitor during propofol-remifentanil anesthesia[J]. Anesthesiology, 2004, 101(6): 1283-1290.
7.	Vereecke HE, Struys MM, Mortier EP. A comparison of bispectral index and ARX-derived auditory evoked potential index in measuring the clinical interaction between ketamine and propofol anaesthesia[J]. Anesthesiology, 2003, 99(4): 802-812.
8.	徐國亭. 麻醉深度指數用于高齡患者全麻期間麻醉深度監測的臨床評價[J]. 第四軍醫大學學報, 2006, 27(19): 1819-1820.

1. Kearse LA, Rosow C, Zaslavsky A, et al. Bispectral analysis of electroencephalogram predicts conscious processing of information during propofol sedation and hypnosis[J]. Anesthesiology, 1998, 88(1): 25-34.
2. Malinga M, Peitfaux F, Lepage JY, et al. Dose-response relationship between target-controlled concentration of propofol and bispectral index[J]. Br J Anaesth, 1998, 80(Suppl): 12.
3. Vanluchene AL, Struys MM, Heyse BE, et al. Spectral enstropy measurement of patient responsiveness during propofol and remifentanil: a comparison with the bispectral index[J]. Br J Anaesth, 2004, 93(5): 645-654.
4. 岳云. 麻醉中知曉的監測與預防[C] . 2006年中華醫學會全國麻醉學術年會知識更新講座, 2006: 316-320.
5. Ibrabim AE, Taraday JK, Kharasch ED, et al. Bispetral index monitoring during sedation with sevoflurane, midazolam, and propofol[J]. Anesthesiology, 2001, 95(5): 1151-1159.
6. Schmidt GN, Bischoff P, Standl T, et al. Comparative evaluation of the Datex-Ohmeda S/5 Entropy Module and the Bispectral Index monitor during propofol-remifentanil anesthesia[J]. Anesthesiology, 2004, 101(6): 1283-1290.
7. Vereecke HE, Struys MM, Mortier EP. A comparison of bispectral index and ARX-derived auditory evoked potential index in measuring the clinical interaction between ketamine and propofol anaesthesia[J]. Anesthesiology, 2003, 99(4): 802-812.
8. 徐國亭. 麻醉深度指數用于高齡患者全麻期間麻醉深度監測的臨床評價[J]. 第四軍醫大學學報, 2006, 27(19): 1819-1820.

West China Medical Journal

Clinical Assessment of Bispectral Index on General Anesthesia

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