脑电双频谱指数在ICU镇静剂使用中的监测作用被引量：9

Application of bispectral index during sedation in the patients in ICU

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摘要目的探讨脑电双频谱指数（BIS值）在监测ICU患者镇静剂使用中的价值。方法人住ICU患者60例，随机分为3组，每组患者持续微量泵泵人异丙酚和咪唑安定，用药量根据BIS值随时调整。Ⅰ组患者使BIS值维持在75～85，Ⅱ组患者使BIS值维持在65～75，Ⅲ组患者使BIS值维持在55～65，并注意维持患者血流动力学稳定。结果用异丙酚和咪唑安定镇静前、后平均动脉压（MAP）和心率（HR）在Ⅰ和Ⅱ组患者问无明显变化（P〉0．05），而在Ⅲ组患者则有所降低（P〈0．05）；Ⅰ组、Ⅱ组、Ⅲ组患者Ramsay评分平均分别为2．2、3．4、4．6；异丙酚用量分别为：（9．54±2．43）μg／kg·min、（12．69±3．12）μg／kg·min、（14．18±2．91）μg／kg·min，咪唑安定用量分别为：（0．23±0．09）μg／kg·min、（0．25±0．07）μg／kg·min、（0．28土0．11）μg／kg·min。结论脑电双频谱指数监测能很好反映患者的镇静深度。应根据ICU不同患者病情要求来取得不同的镇静效果。 Objective To evaluate the value of bispectral index（BIS） monitoring during sedation in the ICU. Methods 60 patients in ICU were randomly divided into three groups. By transfusing propofol and midazolam with injecting pump, the BIS of groups Ⅰ ,Ⅱ and Ⅲ were controlled within 75-85, 65-75 and 55-65, respectively. Results Compared with the pre-sedation, there was no remarkable change in the patients of groups Ⅰ and Ⅲ after sedation（P〉0.05）while there was remarkable change in the patients of group Ⅲ （P〈0.05）. The average score of Ramsay in groups Ⅰ , Ⅱ and Ⅲ were 2.2, 3.4 and 4.6 while the dose of propofol were （9.54±2.43） μg/kg·min, （12.69±3.12） μg/kg·min, （14.18±2.91） μg/kg·min and the dose of midazolam were （0.23±0.09）μg/kg·min, （0.25±0.07） μg/kg·min, （0.28±0.11） μg/kg·min, respectively. Conclusion The application of BIS can make good judgement in the sedation, which showed different choices to different needs to obtain optimistical sedation effect.

作者宋青周飞虎潘亮王秀英

机构地区解放军总医院外科重症监护科

出处《中国康复理论与实践》 CSCD 2006年第1期66-67,共2页 Chinese Journal of Rehabilitation Theory and Practice

关键词脑电双频谱指数异丙酚咪唑安定镇静重症监护室(ICU) bispectral index propofol midazolam sedation intensive care unit（ICU）

分类号 R741.044 [医药卫生—神经病学与精神病学]

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1Leslie K,Seccler DI,Smith WD,et al.Prediction of movement during propofol/nitrous oxide anesthesia[J].Anesthesiology,1996,84:53.
2Jacobi J,Fraser GL,Coursin DB,et al.Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult[J].Crit Care Med,2002,30:119-141.
3Kress JP,Pohlman AS,Hall JB,et al.Sedation and analgesia in the intensive care unit[J].Am J Respir Crit Care Med,2002,166:1024-1028.
4Siegel MD,Matthay M.Sedation in the intensive care unit[J].Clin Pulm Med,2002,9(4):221-228.
5Struys MM,Jensen EW,Smith W,et al.Performance of the ARX-derived auditory evoked potential index as an indicator of anesthetic depth:a comparison with bispectral index and hemodynamic measures during propofol administration[J].Anesthesiology,2002,96:803-816.
6Greif R,Greenwald S,Schweitzer E,et al.Muscle relaxation does not alter hypnotic level during propofol anesthesia[J].Anesth Analg,2002,94(3):604.
7Ibrahim AE,Taraday JK,Kharasch ED,et al.Bispectral index monitoring during sedation with sevoflurane,midazolam and propofol[J].Anesthesiology,2001,95:1151-1159.