BIS监测在老年患者全凭静脉麻醉中的作用.doc

BIS监测在老年患者全凭静脉麻醉中的作用 徐文 谭小云 陈思宇 [摘要] 目的80例择期行腰椎融合术的老年患者，随机分为A 组和B组 ，BIS 监测值调整麻醉深度，）BIS监测使老年患者全身麻醉期间血压和心率波动小，麻醉恢复快，。关键词BIS monitoring in elderly patients with total intravenous anesthesia effect XU Wen, Tang Xiao-yun，CHENG Si-yu （ Department of Anesthesiology,No.413 Hospital of CPLA,Zhoushan 316000,China） [Abstract] Objective To investigate the effects of BIS on hemodynamics and anesthesia recovery in senile patients through general anesthesia. Methods eighty patients undergoing elective line lumbar fusion were randomly divided into two groups of group A and group B with forty cases each,A group adjusted the depth of anesthesia monitoring values according to the BIS, B group adjusted the depth of anesthesia monitoring values according to the experience of the anesthesiologist,records of two groups of patients with blood pressure and heart rate changes during the operation and amesthesia recovery. Results Anesthesia induction period of group A dosage of propofol, the degree of blood pressure to drop, the frequency of intraoperative hypotension occurred was lower than that in group B(P0.05). A group was shorter than group B on finish time, extubation time, anesthesia recovery time, two groups had no intraoperative knows both. Conclusion BIS can stabilize blood pressure and heart rate during the senile patients with general anesthesia,anesthesia rapid recovery,fewer complications. [key words] BIS；senile patient；general anesthesia 老年患者各重要脏器退行性变，麻醉手术耐受力差。术中血压过高会造成术中失血量增多，增加心肌氧耗，引起一系列严重并发症；术中血压过低可引起心肌缺血，脑血栓，重要脏器灌注不足[1]，对老年患者来说都是致命打击。此外老年患者药代动力学和药效动力学显著改变，对各种麻醉药物的耐受性和需要量均下降。过量使用麻醉药不但引起老年病人循环抑制，而且使老年患者在手术麻醉后恢复期往往表现为苏醒延迟，苏醒时间难以预测，增加了手术麻醉的风险。 BIS是一种脑电信号分析方法，它可以直接测量麻醉药和镇静药对大脑皮层作用的效果，从而反映麻醉药和镇静药对麻醉意识深度的影响[2]。临床研究显示脑电双频指数与作用于大脑皮质的药物如丙泊酚之间存在很好的相关性，可评价其麻醉深度[3]，指数范围从0∽100,100和0分别代表完全清醒状态和完全无脑电活动状态, Glass等[4] 研究认为麻醉过程中指数维持在40∽60为最佳麻醉深度。本项研究旨在探讨根据 脑电双频指数值调节麻醉药物剂量，避免麻醉药物过量造成的循环生理抑制，避免麻醉药物过量造成的代谢缓慢，苏醒延迟等问题。 1 资料与方法 1.1 一般资料 2012年3月到2014年11月，实施全凭静脉麻醉的老年患者80例，年龄65∽78岁，其中男性