BIS监测在老年患者腹腔镜胆囊切除术中应用.docVIP

BIS监测在老年患者腹腔镜胆囊切除术中应用 　　【摘要】 目的：探讨术中BIS监测在老年患者腹腔镜胆囊切除术中的应用价值。方法：选择行腹腔镜胆囊切除术老年患者50例，ASA分级Ⅰ～Ⅱ级。患者随机分为BIS组和对照组，每组25例。BIS组术中维持BIS值在40～60，而对照组术中根据麻醉医师经验调控患者麻醉深度。分别记录两组患者术前、插管时、手术开始时及结束时的心率、血压，术中丙泊酚总量以及拔管时间。术后采用MMSE量表对患者认知功能进行评价。结果：BIS组在丙泊酚总量和拔管时间上均显著小于对照组（P0.05），而对照组的平均动脉压在插管时和手术结束时均显著低于BIS组（P0.05）。两组患者均未出现术后认知功能障碍。结论：老年患者腹腔镜胆囊切除术中采用BIS监测能够减少全麻药物用量，缩短患者拔管时间，维持稳定的血流动力学，为患者带来更为安全可控的麻醉。 　　【关键词】 脑电双频指数； 腹腔镜胆囊切除术； 老年患者 　　中图分类号 R614.2 文献标识码 B 文章编号 1674-6805（2015）33-0006-03 　　The Application of BIS Monitoring in Elder Patients in Laparoscopic Cholecystectomy/ZHANG Cheng，WANG Xiao-bin.//Chinese and Foreign Medical Research，2015，13（33）：6-8 　　【Abstract】 Objective：To discuss the application value of BIS monitoring in elder patients in laparoscopic cholecystectomy.Method：50 elder patients who underwent laparoscopic cholecystectomy were randomly divided into the BIS group and the control group，25 cases in each group. ASA class Ⅰ-Ⅱ.The BIS value was maintained between 40 and 60 during the surgery in BIS group.Anesthesia management in control group depended on the anesthesiologists experience.The blood pressure ， heart rate， extubation time and total propofol amount were recorded before surgery， during intubation， at the beginning and end of surgery respectively. The patients cognitive function after surgery were assessed by Mini Mental State Examination.Result：The total propofol amount was significantly lower and the extubation time was significantly shorter in BIS group than those in control group（P0.05）.The mean arterial pressure in control group was significantly lower than that in BIS group at the time of intubation and end of surgery（P0.05）.No postoperative cognitive dysfunction was observed in both groups.Conclusion：BIS monitoring in elder patients in laparoscopic cholecystectomy can decrease the anesthetic agents， shorten the extubation time and maintain stable hemodynamics， which will bring safer and more controllable anesthesia to patients. 　　【Key words】 BIS； Laparosco