摘要
目的通过观察麻醉诱导插管期间熵指数和脑电双频指数（BIS）的变化,比较两者对伤害性刺激（如气管插管）的反应能力。方法20例择期手术病人入室后同时连接熵指数和BIS监护仪,进行常规气管内全麻,记录诱导前、意识消失时、插管前即刻、插管即刻、插管后1、3、5min各时间点所对应的RE、SE、BIS数值以及心率、平均动脉压、脉搏血氧饱和度数值。结果RE、SE、BIS值在诱导开始后逐渐下降,气管插管即刻RE、SE、BIS数值较插管前均明显升高,其中RE值升高最明显（P〈0.01）,随后恢复到插管前水平。气管插管后1minMAP较插管前显著升高（P〈0.01）,气管插管后HR数值较插管前显著增加（P〈0.01）。结论熵指数、BIS和血流动力学指标均能及时反映气管插管刺激,其中RE值较SE、BIS值升高更明显、更快速。
Objective To compare the capabilities of entropy versus bispectral index values reflecting the stimulation of injury. Methods 20 consenting ASA physical status I and II patients scheduled for elective surgery under general anesthesia were evaluated. Both the BIS sensor and entropy sensor electrode strips were simultaneously applied to the patient＇ s forehead. Anesthesia was induced with propofol 2mg/kg, fentanyl 4μg/kg and a- tracurium 0.6mg/kg. Sevoflurane 3% （initial inspired concentration） in combination with intermittent bolus dos- es of atracurium （0. 1mg/kg） were administered for maintenance o{ anesthesia. At the time-point of baseline, loss , before, immediately, and lmin to 5min after intubation, the values of RE,SE ,BIS,HR, MAP and SpO2 were recorded. Results The BIS, RE, and SE values decreased progressivdy from preinduction （baseline） values of 97 ± 1,89 ± 2 and 96 ± 4 to 5 min after intubation values of 41 ± 10,40 ± 10 and 41 ±9, respectivdy. Compared to the values of before intubation, RE, SE and BIS of immediately at intubation were significantly increased, especially the RE value （ P 〈0.01 ）. MAP at the time-point of lmin after intubation were significantly increased compared to the value before intubation（ P 〈 0.01 ）. HR at the time-point of immediately and lmin after intubation were significantly increased compared to the value before intubation（ P 〈0.01）. Conclusion Entropy and BIS indexes and homodynamie indictors （ MAP and HR） can reflect promptly the stimulation of tracheal intubation, especially the RE value.
出处
《中国临床新医学》
2009年第3期215-218,共4页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
基金
广东省卫生厅科研基金项目(No.A2006531)
广州市卫生局科研基金项目(No.2005-YB-045)
关键词
熵指数
脑电双频指数
全身麻醉
气管插管
伤害性刺激
Entropy index
Bispectral index
General anesthesia
Tracheal intubation
Stimulation of injury
