目的：探讨熵指数（ EI）监测麻醉深度对老年纤支镜检查患者喉罩全麻质量及麻醉用药量的影响。方法选取广州中医药大学附属中山医院麻醉科择期行纤支镜检查老年患者64例，男性29例，女性35例，年龄≥64岁，采用随机数字表将患者分为对照组和EI监测组，每组32例。对照组根据传统麻醉深度监测指导用药，EI监测组根据EI指导麻醉用药，麻醉方式均为丙泊酚和瑞芬太尼双通道靶控输注。观察术中各时点心率（ HR）、平均动脉压（ MAP）和血氧饱和度变化；记录丙泊酚、瑞芬太尼用量；记录检查时间、睁眼时间、喉罩拔除时间和清醒时间；观察术后24 h内恶心、呕吐、躁动及术中知晓等不良反应，进行患者满意度和纤支镜检查医师评分。结果相比对照组，丙泊酚和瑞芬太尼用量明显减少；睁眼时间、喉罩拔除时间和清醒时间缩短；术后24 h恶心、呕吐发生率降低（P＜0．05）；患者满意度及纤支镜检查医师评分增高（P＜0．05）。结论 EI监测能够提高老年纤支镜检查患者喉罩全麻的麻醉质量，节省麻醉费用。%Objective To determine the effect of using entropy index ( EI ) for monitoring anesthesia depth on the quality and anesthetic dose of laryngeal mask anesthesia in the elderly patients undergoing fiberoptic bronchoscopy .Methods Sixty-four elderly patients (29 males and 35 females, over 64 years old) who underwent elective fiberoptic bronchoscopy in our hospital were randomized into control (Group C) and EI monitoring group (Group EI), with 32 cases in each group.The drug used in Group C were adjusted according to the results of conventional anesthetic depth monitoring , while those of Group EI were under the guidance of EI .Propofol and remifentanil dual channel target controlled infusion was applied for the both groups .Heart rate (HR), mean arterial pressure ( MAP) and oxygen saturation at each time point and the doses of propofol and remifentanil were detected .The time for checking , eye opening, extubation and awakening was also recorded .The adverse reactions such as nausea , vomitting and restless within 24 h postop-eratively and intraoperative awareness were observed .Patient ’ s and bronchoscopy physicians ’ satisfaction scores were evaluated . Results Compared with Group C , Group EI had less amounts of propofol and remifentanil , shorter time of eye opening , extubation and awakening, lower incidences of nausea and vomitting in 24 h after operation (P<0.05), and higher patient’s and physician’s satisfaction scores (P<0.05).Conclusion EI monitoring can improve the quality and save the cost of laryngeal mask anesthesia in the elderly patients undergoing fiberoptic bronchoscopy .
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