丙泊酚联合瑞芬太尼全身麻醉下颧弓部与额部脑电双频指数的比较

摘要

目的：比较分析神经外科手术中丙泊酚联合瑞芬太尼全身麻醉下颧弓部与额部脑电双频指数( BIS)的相关性。方法选择神经外科手术患者20例，术中采用丙泊酚联合瑞芬太尼靶控输注进行全凭静脉麻醉。每例患者同侧颧弓部和额部分别放置两个BIS电极，采集清醒(t1)、气管插管(t2)、切皮(t3)、手术结束(t4)，气管拔管(t5)各时间点BIS 值进行分析。结果在t1时颧弓部BIS值为(84.85±9.64)，明显低于额部的(88.95±6.42，P<0.01)，而在t2~t5时颧弓部与额部的BIS值比较差异无统计学意义(P>0.05)。散点图分析显示颧弓部与额部BIS 值在麻醉前后具有正相关性( R2＝0.892，P＝0.000)。结论神经外科手术麻醉期间，当额部电极放置受限时，颧弓部可以作为替代部位放置电极进行监测。%Objective To compare the bispectral index score ( BIS) correlationbetween standard frontal sensor position and an alternative zygomatic position under general anesthesia with propofol combined with remifentanil during neurosurgery. Methods Twenty patients undergoing neurosurgery were enrolled. Everyone received total intravenous anesthesia by target-controlled infusion of propofol and remifentanil. Two BISTM Quatro sensors mounted on the frontal and zygomatic regions were connected to BIS VistaTM monitors on each patient during general anesthesia.Data from each position were collected and analyzed at the time of awakening ( t1 ) , intubation ( t2 ) , incision ( t3 ) , the end of surgery ( t4 ) , and extubation ( t5 ) . Results At t1 , zygomatic BIS(88.95±6.42) was significantly lower than frontal BIS (84.85±9.64,P<0.01).But during anesthesia,different of BIS value was no statistical significance between the standard frontal position and an alternative zygomatic position(P>0.05). Scatter plot analysis revealed a significant correlation between BIS of frontal positionand that of zygomatic position( R2=0.892,P=0.000) . Conclusion During the anesthesia maintenance period,the zygomatic position can be availably used as an alternative position for monitoring if the operative field renders the standard frontal position unavailable.