指光电容积脉搏波技术与脑状态指数用于麻醉深度监测的比较

发布时间：2019-03-13 07:53

【摘要】：目的:指端光电容积脉搏波(PPG)与脑状态指数(CSI)用于麻醉深度监测的对比性观察。方法:全麻下行甲状腺或乳腺手术患者93例,气管插管前靶控输注(TCI)异丙酚进行麻醉诱导,靶浓度从0.5mg/L开始,每隔3 min递增0.5 mg/L,直至改良清醒镇静评分(MOAAS)为0后,以原靶浓度继续泵注。持续描记指端PPG,记录CSI,每隔30 s行MOAAS评分。计算脉搏波参数与MOAAS的相关性及各指标预测MOAAS评分的预测概率(Pk)。结果 :麻醉诱导开始至气管插管前,PPGA值在MOAAS 4级至3级、3级至2级时显著上升(P0.05);CSI值在各相邻MOAAS评分间比较差异均有统计学意义(P0.05)。PPGA、PBI、CSI与MOAAS的相关系数分别为-0.55、-0.30、0.93,在不同MOAAS评分时的Pk值分别为0.64、0.54、0.93。气管插管及切皮前后PPGA、PBI值比较差异有统计学意义(P0.05)。结论:麻醉深度监测中,CSI可很好的监测镇静深度,PPGA、PBI可较好地反映全身麻醉下伤害性感受反应,故PPGA结合CSI可完善麻醉深度的监测。
[Abstract]:Objective: to compare the digital photoelectric volume pulse wave (PPG) and the cerebral state index (CSI) in monitoring the depth of anesthesia. Methods: 93 patients undergoing thyroid or breast surgery under general anesthesia were anesthetized by target-controlled infusion of (TCI) propofol before endotracheal intubation. The target concentration began with 0.5mg/L and increased by 0.5mg/L every 3 min. Until the improved sobriety sedation score (MOAAS) is 0, continue to pump with the original target concentration. Continuous fingertip PPG, was used to record the MOAAS score of CSI, every 30 s. The correlation between pulse wave parameters and MOAAS and the prediction probability (competition) of each index to predict MOAAS score were calculated. Results: the PPGA value increased significantly from grade 4 to grade 3 of MOAAS and from stage 3 to grade 2 of anesthesia induction before tracheal intubation (P0.05). The correlation coefficients of CSI, PBI,CSI and MOAAS were-0.55, 0.30 and 0.93, respectively. The PK values of different MOAAS scores were 0.64, 0.54 and 0.93 respectively, and the correlation coefficients of PPGA, PGA and MOAAS were-0.55, 0.30, 0.93, 0.64, 0.54, 0.93 respectively, and that of PPGA and PGA were-0.55, 0.30 and 0.93 respectively. There was significant difference in PPGA, PBI before and after endotracheal intubation and skin incision (P0.05). Conclusion: in the depth monitoring of anesthesia, CSI can monitor the depth of sedation well, and PPGA,PBI can well reflect the nociceptive response under general anesthesia. Therefore, PPGA combined with CSI can perfect the monitoring of the depth of anesthesia.
【作者单位】：南昌大学第二附属医院麻醉科;
【分类号】：R614

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