脑电双频指数在老年患者髋关节置换手术中的应用

Application of bispectral index in hip replacement surgery in elder patient

关键词:  老年患者  脑电双频指数  髋关节置换术

Key words:  elder patients  bispectral index  hip replacement surgery

摘要:

[目的] 对全麻行髋关节置换术的老年患者行术中脑电双频谱指数（bispectral index, BIS）监测，探讨BIS在老年患者中的应用。[方法]选择2011年10月—12月，年龄≥75岁，ASAⅠ~Ⅲ，择期全麻行髋关节置换术的患者22例为实验组（B组），术中行BIS监测；上年同期术中未行BIS监测的相同病例18例为对照组（N组）。比较两组丙泊酚用量，术中循环维持和管理，手术室内拔管例数，及术后24 h ICU滞留情况。[结果]丙泊酚用量两组差异有显著性意义，B组为（135.37±35.09）mg·h-1，小于N组（176.11±42.13）mg·h-1，P<0.05；术中血压及心率比较差异无显著意义，P>0.05，但B组使用血管收缩药的例数少于N组，P<0.05；手术室内拔管例数B组多于N组，P<0.05；术后24 h ICU滞留两组差异无显著意义，P>0.05。[结论]老年患者术中行BIS监测，可减少丙泊酚用量，术中循环稳定，增加手术室内拔管的成功率，改善围手术期转归。

Abstract:

[Objective] To study the feasibility of bispectral index in hip replacement surgery in elder patients. [Methods] From October to December 2011, patients older than 75 years, ASAⅠ-Ⅲ, who were scheduled for hip replacement surgery under general anesthesia, were in observation group (Group B). The other patients in the same time last year were in contrast group (Group N). BIS was used in Group B, while Group N was not. Blood pressure, heart rate, the dosage of anesthetic drugs and vascular drugs were recorded. Patients who were extubated at the end of surgery were also recorded; patients sent to ICU were monitored 24 hours later. [Results] There was significant difference in the consumption of propfol. group B (135.37±35.09) mg·h-1, obviously less than Group N (176.11±42.13) mg·h-1, P<0.05; intraoperative blood pressure and heart rate is comparable, but ephedrine or phenylephrine used intraoperatively were different significantly, Group B is less than Group N, P>0.05; there were more patients in Group B than in Group N extubated successfully in the operating room, P<0.05; Postoperative ICU stay were no difference P<0.05. [Conclusion] BIS is feasible to be used in elderly patients in this kind of surgery. It can reduce the dosage of propfol, help to maintain intraoperative circulation, and was good to improve perioperative outcome.