脑电双频指数在临床麻醉中的应用现状
摘要
<正>理想的全身麻醉是术中无痛觉和无意识、肌肉松弛、抑制应激和自主反射、血流动力学稳定、术后苏醒完善且无相关并发症。诸多体征是反映麻醉深度的传统主观指标,如血压、心率、呼吸幅度及节律、瞳孔、肌肉松度等。随着电子计算机技术的发展,客观、量化的镇静深度监测技术有了新的突破,脑电双频指数(BIS)在临床的应用尤为广泛。本文就BIS在临床麻醉中的现状、局限及前景进行综述。
引文
[1]黄岩,李邦翅.麻醉深度监测常用设备原理及其临床应用[J].医疗卫生装备,2012,(2):85.
[2]Bell JK,Laasch HU,Wilbraham L.Bispectral index monitoring for conscious sedation in intervention:better,safer,faster[J].Clinical Radiology,2004,59(12):1106.
[3]徐源,李天佐,陈磊,等.脑电双频指数在全凭静脉麻醉中的作用[J].临床麻醉学杂志,2010,26(07):578.
[4]阮绪广,詹鸿,江伟航,等.七氟醚、异氟醚不同呼气末浓度对熵和脑电双频指数的影响[J].临床麻醉学杂志,2008,24(7):571.
[5]R Shalbaf,H BEHNAM,J SLEIGH.Measuring the effects of sevoflurane on electroencephalogram using sample entropy[J].Acta Anaesthesiol Scand,2012,7:113.
[6]王键,尹秀茹,仇波,等.氯胺酮对脑电双频指数和熵指数的影响[J].神经疾病与精神卫生,2013,(06):113.
[7]程宏霞,王晓冬,邱颐.熵指数和脑电双频指数在学龄期儿童麻醉深度监测中的对比研究[J].内蒙古医学杂志,2016,48(01):8.
[8]Menigaux C,Guignard B,Nourredine K,et al.BIS variation at intubation with different remifentanil doses[J].Anesthesiology,1998,89:103.
[9]Greif R,Greenwald S,Schweitzer E,et al.Muscle relaxation does not alter hypnotic level during propofol anesthesia[J].Anesth Analg,2002,94(3):604.
[10]沈亮言,谢言虎,方才.肌松药对脑电双频指数监测麻醉深度的影响[J].国际麻醉学与复苏杂志,2010,(4):372.
[11]Schultz AS,Grouven M,Thomas U K.Comparison of Narcotrend Index,Bispectral Index,spectral and entropy parameters during induction of propofol-remifentanil anaesthesia[J].Journal of clinical monitoring and computing,2008,2(2):103.
[12]Panousis P,Heller AR,Burghardt MB,et al.The effects of electromyographic activity on the accuracy of the Narcotrend(R)monitor compared with the Bispectral Index during combined anaesthesia[J].Anaethesia,2007,62:868.
[13]马颖,乔杉,梁宇杰,等.对镇静治疗机械通气患者行BIS监测的护理现状[J].国际护理学杂志,2012,(8):1345.
[14]Stammet P,Werer C,Mertens L.Bispectral index(BIS)helps predicting bad neurological outcome in comatose survivors after cardiac arrest and induced therapeutic hypothermia[J].Resuscitation,2009,(4):437.
[15]Astrid VF,Franziska K,Steffen Rex,et al.Bispectral index monitoring during balanced xenon or sevoflurane anaesthesia in elderly patients[J].European Journal of Anaesthesiology,2010,27(10):906.
[16]Sessler DI,Sigl JC,Kelley SD,et al.Hospital stay and mortality are increased in patients having a“triple low”of low blood pressure,low bispectral index,and low minimum alveolar concentration of volatile anesthesia[J].Anesthesiology,2012,116:1195.
[17]Punjasawadwong Y,Phongchiewboon A,Bunchungmongkol N.Bispectral index for improving anaesthetic delivery and postoperative recovery[J].Cochrane Database of Systematic Reviews,2014,6:3843.
[18]Maheshwari A,McCormick PJ,Sessler DI,et al.Prolonged concurrent hypotension and low bispectral index(‘double low’)are associated with mortality,serious complications,and prolonged hospitalization after cardiac surgery[J].British Journal of Anesthesia,2017,119(1):40.
[19]Indu Kapoor,Hemanshu Prabhakar,Charu Mahajan.Can pediatric bispectral index sensor replace adult bispectral index sensor for depth of anesthesia monitoring?[J].Asian journal of neurosurgery,2018,13(2):529.
[20]张建敏,王芳,辛忠,等.脑电双频指数在不同年龄患儿丙泊酚复合瑞芬太尼静脉麻醉中的临床观察[J].中华医学杂志,2008,(41):2904.
[21]陈丽丽,郑超,吕红,等.脑电双频指数用于监测婴幼儿七氟醚麻醉深度的可行性[J].中国医药导刊,2017,19(09):905.
[22]Tokuwaka J,Satsumae T,Mizutani T,et al.The relationship between age and minimum alveolar concentration of sevoflurane for maintaining bispectral index below 50in children[J].Anaesthesia,2015,70(3):318.
[23]Kumar TV,Puri GD.Bispectral index as a possible early marker of cerebral hypoperfusion[J].Anesth Essays Res,2013,7(3):405.
[24]Akavipat P,Hungsawanich N,Jansin R.Alternative Placement of Bispectral Index Electrode for Monitoring Depth of Anesthesia during Neurosurgery[J].ACTA MEDICA OKAYAMA,2014,68(3):151.
[25]朱小兵,吴论,刘志群,彭学强.体位因素对全凭静脉麻醉患者脑电双频指数的影响[J].临床麻醉学杂志,2013,29(07):708.
[26]Duarte LT,Saraiva RA.When the bispectral index(bis)can give false results[J].Revista brasileira de anestesiologia,2009,59(1):99.
[27]Han C,Ge SJ,Huang SQ,et al.Influence of different menstrual phases on the Bispectral Index during dexmedetomidine sedation[J].J Med Sci,2016,32(11):586.
[28]Villafranca A,Thomson IA,Grocott HP,et al.The impact of bispectral index versus end-tidal anesthetic concentration-guided anesthesia on time to tracheal extubation in fast-track cardiac surgery[J].Anesth Analg,2013,116:541.
[29]干朝晖,张立群.脑电双频指数与严重颅脑外伤程度的相关性及预后分析[J].中国现代医生,2011,49(22):22.
[30]周路阳,傅素娥,徐建国.全身麻醉中脑电双频指数与脑氧代谢率的相关性[J].临床麻醉学杂志,2006(12):896.
[31]Kumar TV,Puri GD.Bispectral index as a possible early marker of cerebral hypoperfusion[J].Anesth Essays Res,2013,7(3):405.
[32]Park JH,Oh JH,Choi SP.Neurologic outcome after out-of-hospital cardiac arrest could be predicted with the help of bispectralindex during early targeted temperature management[J].Scandinavian journal of trauma,resuscitation and emergency medicine,2018,26(1):59.
[33]Eertmans W,Genbrugge C,Vander L M,et al.The prognostic value of bispectral index and suppression ratio monitoring after out-of-hospital cardiac arrest:aprospective observational study[J].Ann Intensive Care,2018,8:34.
[2]Bell JK,Laasch HU,Wilbraham L.Bispectral index monitoring for conscious sedation in intervention:better,safer,faster[J].Clinical Radiology,2004,59(12):1106.
[3]徐源,李天佐,陈磊,等.脑电双频指数在全凭静脉麻醉中的作用[J].临床麻醉学杂志,2010,26(07):578.
[4]阮绪广,詹鸿,江伟航,等.七氟醚、异氟醚不同呼气末浓度对熵和脑电双频指数的影响[J].临床麻醉学杂志,2008,24(7):571.
[5]R Shalbaf,H BEHNAM,J SLEIGH.Measuring the effects of sevoflurane on electroencephalogram using sample entropy[J].Acta Anaesthesiol Scand,2012,7:113.
[6]王键,尹秀茹,仇波,等.氯胺酮对脑电双频指数和熵指数的影响[J].神经疾病与精神卫生,2013,(06):113.
[7]程宏霞,王晓冬,邱颐.熵指数和脑电双频指数在学龄期儿童麻醉深度监测中的对比研究[J].内蒙古医学杂志,2016,48(01):8.
[8]Menigaux C,Guignard B,Nourredine K,et al.BIS variation at intubation with different remifentanil doses[J].Anesthesiology,1998,89:103.
[9]Greif R,Greenwald S,Schweitzer E,et al.Muscle relaxation does not alter hypnotic level during propofol anesthesia[J].Anesth Analg,2002,94(3):604.
[10]沈亮言,谢言虎,方才.肌松药对脑电双频指数监测麻醉深度的影响[J].国际麻醉学与复苏杂志,2010,(4):372.
[11]Schultz AS,Grouven M,Thomas U K.Comparison of Narcotrend Index,Bispectral Index,spectral and entropy parameters during induction of propofol-remifentanil anaesthesia[J].Journal of clinical monitoring and computing,2008,2(2):103.
[12]Panousis P,Heller AR,Burghardt MB,et al.The effects of electromyographic activity on the accuracy of the Narcotrend(R)monitor compared with the Bispectral Index during combined anaesthesia[J].Anaethesia,2007,62:868.
[13]马颖,乔杉,梁宇杰,等.对镇静治疗机械通气患者行BIS监测的护理现状[J].国际护理学杂志,2012,(8):1345.
[14]Stammet P,Werer C,Mertens L.Bispectral index(BIS)helps predicting bad neurological outcome in comatose survivors after cardiac arrest and induced therapeutic hypothermia[J].Resuscitation,2009,(4):437.
[15]Astrid VF,Franziska K,Steffen Rex,et al.Bispectral index monitoring during balanced xenon or sevoflurane anaesthesia in elderly patients[J].European Journal of Anaesthesiology,2010,27(10):906.
[16]Sessler DI,Sigl JC,Kelley SD,et al.Hospital stay and mortality are increased in patients having a“triple low”of low blood pressure,low bispectral index,and low minimum alveolar concentration of volatile anesthesia[J].Anesthesiology,2012,116:1195.
[17]Punjasawadwong Y,Phongchiewboon A,Bunchungmongkol N.Bispectral index for improving anaesthetic delivery and postoperative recovery[J].Cochrane Database of Systematic Reviews,2014,6:3843.
[18]Maheshwari A,McCormick PJ,Sessler DI,et al.Prolonged concurrent hypotension and low bispectral index(‘double low’)are associated with mortality,serious complications,and prolonged hospitalization after cardiac surgery[J].British Journal of Anesthesia,2017,119(1):40.
[19]Indu Kapoor,Hemanshu Prabhakar,Charu Mahajan.Can pediatric bispectral index sensor replace adult bispectral index sensor for depth of anesthesia monitoring?[J].Asian journal of neurosurgery,2018,13(2):529.
[20]张建敏,王芳,辛忠,等.脑电双频指数在不同年龄患儿丙泊酚复合瑞芬太尼静脉麻醉中的临床观察[J].中华医学杂志,2008,(41):2904.
[21]陈丽丽,郑超,吕红,等.脑电双频指数用于监测婴幼儿七氟醚麻醉深度的可行性[J].中国医药导刊,2017,19(09):905.
[22]Tokuwaka J,Satsumae T,Mizutani T,et al.The relationship between age and minimum alveolar concentration of sevoflurane for maintaining bispectral index below 50in children[J].Anaesthesia,2015,70(3):318.
[23]Kumar TV,Puri GD.Bispectral index as a possible early marker of cerebral hypoperfusion[J].Anesth Essays Res,2013,7(3):405.
[24]Akavipat P,Hungsawanich N,Jansin R.Alternative Placement of Bispectral Index Electrode for Monitoring Depth of Anesthesia during Neurosurgery[J].ACTA MEDICA OKAYAMA,2014,68(3):151.
[25]朱小兵,吴论,刘志群,彭学强.体位因素对全凭静脉麻醉患者脑电双频指数的影响[J].临床麻醉学杂志,2013,29(07):708.
[26]Duarte LT,Saraiva RA.When the bispectral index(bis)can give false results[J].Revista brasileira de anestesiologia,2009,59(1):99.
[27]Han C,Ge SJ,Huang SQ,et al.Influence of different menstrual phases on the Bispectral Index during dexmedetomidine sedation[J].J Med Sci,2016,32(11):586.
[28]Villafranca A,Thomson IA,Grocott HP,et al.The impact of bispectral index versus end-tidal anesthetic concentration-guided anesthesia on time to tracheal extubation in fast-track cardiac surgery[J].Anesth Analg,2013,116:541.
[29]干朝晖,张立群.脑电双频指数与严重颅脑外伤程度的相关性及预后分析[J].中国现代医生,2011,49(22):22.
[30]周路阳,傅素娥,徐建国.全身麻醉中脑电双频指数与脑氧代谢率的相关性[J].临床麻醉学杂志,2006(12):896.
[31]Kumar TV,Puri GD.Bispectral index as a possible early marker of cerebral hypoperfusion[J].Anesth Essays Res,2013,7(3):405.
[32]Park JH,Oh JH,Choi SP.Neurologic outcome after out-of-hospital cardiac arrest could be predicted with the help of bispectralindex during early targeted temperature management[J].Scandinavian journal of trauma,resuscitation and emergency medicine,2018,26(1):59.
[33]Eertmans W,Genbrugge C,Vander L M,et al.The prognostic value of bispectral index and suppression ratio monitoring after out-of-hospital cardiac arrest:aprospective observational study[J].Ann Intensive Care,2018,8:34.