摘要
目的评价听觉诱发电位指数（AAI）监测患者异氟醚吸入麻醉深度的准确性。方法30例择期全麻手术患者，ASAⅠ或Ⅱ级。麻醉诱导气管插管后15min开始以3L／min氧流量（高流量）洗入，12min后调整为0．5L／min氧流量（低流量）维持，调节异氟醚挥发罐刻度，使异氟醚呼气末浓度依次为0．8MAC、1．0MAC和1．3MAC，每个浓度维持20min，分别于诱导前（基础状态）、诱导后即刻、吸入异氟醚前即刻、高流量洗入3min、6min、9min、12min及低流量维持期异氟醚呼气末浓度分别为0．8MAC、1．0MAC、1．3MAC时监测平均动脉压、心率和AAI。结果与吸入异氟醚前即刻比较，高流量洗入期AAI降低，且高流量洗入期AAI逐渐降低（P〈0．05）。低流量维持期异氟醚呼气末浓度为0．8MAC、1．0MAC和1．3MAC时，随浓度的增加AAI逐渐降低（P〈0．05），在此范围内AAI与异氟醚呼气末浓度的相关系数为-0．896（P〈0．01）。结论AAI可用于监测患者异氟醚吸入麻醉的深度。
Objective To evaluate the accuracy of auditory evoked potential index （AAI） in monitoring anesthetic depth during isoflurane anesthesia. Methods Thirty ASA Ⅰ or Ⅱ patients aged 18-55 yr undergoing operations performed under general anesthesia were studied. The patients were unpremedicated. Anesthesia was induced with midazolam 0,05 mg/kg, fentanyl 3 μg/kg and propofol 1 mg/kg. Tracheal intubation was facilitated with recuronium 0, 1 mg/kg, The patients were mechanically ventilated （VT 8-10 ml/kg, RR 12 bpm, I：E 1：2）, PETCO2 was maintained at 35-40 mm Hg, Anesthesia was maintained with isoflurane inhalation and intermittent iv boluses of vecuronium. Isoflurane was started with high-flow （ FGF 3 L/min） for 12 min followed by low-flow （ FGF 0.5 L/min） . The inspired isoflurane concentration was set at 3% , ECG, MAP, HR, SpO2, end-tidal isoflurane concentration and AAI were continuously monitored during anesthesia and recorded before induction of anesthesia （baseline）, immediately after induction, immediately before isoflurane inhalation, at 3,6, 9 and 12 min during high-flow wash-in and at end-tidal isoflurane concentration of 0.8 MAC, 1.0 MAC and 1.3 MAC during low-flow. Results AAI was decreasing gradually while the end-tidal isoflurane concentration was increasing during high-flow wash-in, During low-flow there was negative correlation between AAI and end-tidal isoflurane concentration （ r = -0.896, P 〈 0.01）, Conclusion AAI can be used to monitor the depth of anesthesia during isoflurane anesthesia.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2008年第2期115-117,共3页
Chinese Journal of Anesthesiology
基金
厦门市卫生局青年科研基金资助项目（WQK0508）.志谢 诚挚地感谢黄宇光教授对本文的悉心指导
关键词
诱发电位
听觉
监测
手术中
异氟醚
麻醉
吸入
Evoked potentials, auditory
Monitoring, intraoperative
Isoflurane
Anesthesia, inhalation
