肝脏部分切除术中BIS指导麻醉深度的临床应用(1)
[摘要] 目的 探讨脑电双频指数(bispectral index，BIS)指导麻醉深度对肝脏部分切除患者术后苏醒的影响。 方法 选择2013年1月～2015年12月在我院行全麻下肝脏部分切除术患者54例为研究对象。54例患者按照入院单双号分为BIS组及对照组各27例。BIS组采用BIS指导麻醉深度，对照组不采用BIS指导麻醉深度。比较两组的苏醒时间等，MOAA/S评分达1分、2分、3分及4分时BIS值及所需要时间，术中术后不良反应情况。 结果 BIS组睁眼时间、合作时间、拔管时间、清醒时间、定向力恢复时间以及出麻醉后监测治疗室(postanesthesia care unit，PACU)时间均显著短于对照组，差异有高度统计学意义(P<0.01)。BIS组MOAA/S评分达4分时的BIS值显著高于对照组，差异有高度统计学意义(P<0.01)。BIS组MOAA/S评分达1分、2分、3分及4分时所需要时间显著短于对照组，差异有高度统计学意义(P<0.01)。术后24 h随访两组均无术中知晓患者。两组术中体动、苏醒延迟、术后躁动发生率比较差异无统计学意义(P>0.05)。 结论 肝脏部分切除术中BIS指导麻醉深度能够良好控制患者术中的麻醉深度，避免麻醉过深，缩短术后苏醒时间。
[关键词] BIS；麻醉深度；肝脏部分切除；术后苏醒
[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701(2016)25-0099-04
Clinical application of BIS in guiding the depth of anesthesia during partial hepatectomy
XIE Airong XIA Lianxiang ZHANG Xiaohua
Department of Anesthesia， Ji'an First People's Hospital in Jiangxi Province， Ji'an 343000， China
[Abstract] Objective To discuss clinical application of BIS in guiding the depth of anesthesia during partial hepatectomy. Methods A total of 54 cases with partial hepatectomy under general anesthesia from Jan 2013 to Dec 2015 were selected as subjects. 54 cases were divided into BIS group and control group according to admission odd numbers and even numbers， each group of 27 cases. BIS group was used BIS to guide the depth of anesthesia. Control group was not used BIS to guide the depth of anesthesia. Wake time， BIS value and time required at MOAA/S score of 1 point， 2 points， 3 points and 4 points， and adverse reaction after operation of two groups were compared. Results The open time， cooperation time， extubation time， recovery time， recovery time and out of PACU time of BIS group were earlier than control group(P<0.01). BIS score at MOAA/S of 4 of BIS group was higher than control group(P<0.01). The time of MOAA/S of 1， 2， 3， 4 points of BIS group was earlier than control group(P<0.01). There was no intraoperative awareness of the patients in the two groups following up after 24 h. Intraoperative body movement， delayed recovery and postoperative agitation rates showed no significant difference between two groups(P>0.05). Conclusion BIS in guiding the depth of anesthesia during partial hepatectomy can control depth of anesthesia， avoid the depth of anesthesia， and shorten the postoperative recovery time.
[Key words] BIS； Depth of anesthesia； Partial hepatectomy； Postoperative recovery
肝脏部分切除术是目前治疗多种肝脏疾病的有效方法。因肝脏功能受损、手术时间长、手术创伤大、术中出血多等特点，术中麻醉管理要求也更高。肝脏部分切除术的患者常存在术后苏醒时间较长、苏醒质量较差等情况，与肝脏功能不全影响麻醉药物药代动力学及药效学有关[1，2]。本文在肝脏部分切除术中采用BIS指导麻醉深度，取得了较好的效果。现报道如下。, http://www.100md.com(谢爱荣 夏连香 张小花)
[关键词] BIS；麻醉深度；肝脏部分切除；术后苏醒
[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701(2016)25-0099-04
Clinical application of BIS in guiding the depth of anesthesia during partial hepatectomy
XIE Airong XIA Lianxiang ZHANG Xiaohua
Department of Anesthesia， Ji'an First People's Hospital in Jiangxi Province， Ji'an 343000， China
[Abstract] Objective To discuss clinical application of BIS in guiding the depth of anesthesia during partial hepatectomy. Methods A total of 54 cases with partial hepatectomy under general anesthesia from Jan 2013 to Dec 2015 were selected as subjects. 54 cases were divided into BIS group and control group according to admission odd numbers and even numbers， each group of 27 cases. BIS group was used BIS to guide the depth of anesthesia. Control group was not used BIS to guide the depth of anesthesia. Wake time， BIS value and time required at MOAA/S score of 1 point， 2 points， 3 points and 4 points， and adverse reaction after operation of two groups were compared. Results The open time， cooperation time， extubation time， recovery time， recovery time and out of PACU time of BIS group were earlier than control group(P<0.01). BIS score at MOAA/S of 4 of BIS group was higher than control group(P<0.01). The time of MOAA/S of 1， 2， 3， 4 points of BIS group was earlier than control group(P<0.01). There was no intraoperative awareness of the patients in the two groups following up after 24 h. Intraoperative body movement， delayed recovery and postoperative agitation rates showed no significant difference between two groups(P>0.05). Conclusion BIS in guiding the depth of anesthesia during partial hepatectomy can control depth of anesthesia， avoid the depth of anesthesia， and shorten the postoperative recovery time.
[Key words] BIS； Depth of anesthesia； Partial hepatectomy； Postoperative recovery
肝脏部分切除术是目前治疗多种肝脏疾病的有效方法。因肝脏功能受损、手术时间长、手术创伤大、术中出血多等特点，术中麻醉管理要求也更高。肝脏部分切除术的患者常存在术后苏醒时间较长、苏醒质量较差等情况，与肝脏功能不全影响麻醉药物药代动力学及药效学有关[1，2]。本文在肝脏部分切除术中采用BIS指导麻醉深度，取得了较好的效果。现报道如下。, http://www.100md.com(谢爱荣 夏连香 张小花)