熵指数麻醉深度监测仪在全麻苏醒期患者意识监测的应用.pdfVIP

临床麻醉学杂志2007年 l2月第23卷第l2期 J Clin Anesthesiol，December 2007，Vo1．23，No．12 ． 临 床 研 究 · 熵指数麻醉深度监测仪在全麻苏醒期 患者意识监测的应用 王晓亮 史宏伟 葛亚力 高玉洁 张媛 朱健明 【摘要】 目的 评价熵指数在全麻苏醒期监测患者意识状态的效能。方法 选择 25例 ASA I或Ⅱ级在全麻下择期行胆囊切除术的患者，手术期间通过丙泊酚、雷米芬太尼和阿曲库铵维持麻 醉，术毕采用熵指数监测麻醉深度，采用镇静／警觉(OAA／S)评分评估患者全麻后意识恢复程度，并 记录不同0AA／s评分时所对应熵指数(RE和 SE)的值。计算这些参数对应意识状态的相关系数 (r)。结果 r 、rRE与患者全麻苏醒期意识状态变化显著相关(PO．O1)。结论 熵指数在全麻苏 醒期能够及时有效地反映患者意识状态的变化。 【关键词】 熵指数；全麻苏醒期；血流动力学；意识状态 Application of entropy anesthesia depth monitoring in evaluating consciousness recovery during emergence of general anesthesia WANG Xiao—liang，SHI Hong-wei，GE Ya—li，et a1．Deparment of Anesthesiology，Nanjing First Hospital Affiliated to Nanjing Medical University，Nanjing 210006， China [Abstract] Objective To evaluate the predictive effect of entropy as a measure of anesthesia depth nionitoring during emrgence from general anesthesia．Methods Twenty-five ASA class I orⅡ patients undergoing cholecystectomy were anesthetized with remifentanil，propofol，atracurium． Entropy monitoring was carried out during anesthesia．The level of consciousness was assessed during emergence from anesthesia using OAA／S scale．Results Response entropy and status entropy were correlated wel1 with the changes of consciousness during anesthesia emergence．Conclusion Entropy monitor can be used for predicting patient S consiousness recovery during the emergence of general anesthesia． [Key words】 Entropy；Emergence of general anesthesia；Hemodynamics；Consciousness 熵指数Ⅲ是近年来监测麻醉深度的新指标，包 泊酚1 mg／kg。术中以丙泊酚8 mg·kg ·h_。、雷米芬 括反应熵(RE)和状态熵(SE)两个参数，用于诱导 太尼0．2 g·kg ·min_。、阿曲库铵0．5 mg·kg ·h 期和术中对患者的监测，为提高麻醉质量提供了有 维持。手术结束前30 min停阿曲库铵，关腹时静脉 效技术手段。本研究通过熵指数的监测，评价其对 给曲马多2 mg／kg，结束时停丙泊酚和雷米芬太尼。 全麻苏醒期患者意识恢复预测的效能。 手术结束后患者进入麻醉恢复室，继续监测ECG、