Bispectral index and regional cerebral oxygen saturation during propofol/N2O anesthesia
Bispectral index and regional cerebral oxygen saturation during propofol/N2O anesthesia
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DOI：
10.1007/bf03022500
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发表时间：
2006-04-01
期刊：
影响因子：
--
通讯作者：
Goto, F
中科院分区：
文献类型：
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作者：
Kanemaru, Y;Nishikawa, K;Goto, F
目的：进行了一项研究，以比较咪达唑仑，异氟醚和氨茶碱的影响（可能拮抗麻醉作用）对异丙酚/N2 O麻醉期间脑电双频指数（BIS）和局部脑氧饱和度（rSO（2））的影响，并检验药物引起的BIS值变化伴随rSO（2）变化的假设。36例患者采用全麻，持续输注丙泊酚维持BIS值40 S。基线记录后，患者被随机分配接受咪达唑仑，异氟烷或氨茶碱。记录60分钟的脑电双频指数值、使用近红外光谱的rSO（2）和血流动力学参数。咪唑安定注射后5分钟，中心点0.05 mg/kg（-1）显著降低BIS，从47.8 ± 5.4降至35.0 ± 4.5（P < 0.001 vs对照组），而rSO（2）无变化。同样，异氟醚（1.1%潮气末）将BIS从42.5 ± 7.5降至27.8 ± 6.9（P < 0.001），而不影响rSO（2）。相比之下，氨茶碱（3 mg中心点kg（-1））与BIS在注射后5分钟从41.6 +/- 2.1增加到48.3 +/- 9.2相关（P < 0.05），而不影响rSO（2）。结论：在丙泊酚麻醉期间，咪达唑仑或异氟烷诱导的BIS降低不伴有rSO（2）降低。氨茶碱显著增加丙泊酚麻醉期间的BIS评分，表明氨茶碱可以拮抗，至少部分，丙泊酚的镇静作用。
Purpose: A study was undertaken to compare the influence of midazolam, isoflurane, and aminophylline (which may antagonize anesthetic action) on bispectral index (BIS) and regional cerebral oxygen saturation (rSO(2)) during propofol/N2O anesthesia, and to test the hypothesis that the drug-induced changes in BIS values are accompanied by a change in rSO(2).Methods: General anesthesia was administered to 36 patients with a continuous infusion of propofol to maintain a BIS value of 40 S. After baseline recordings, patients were randomly assigned to receive either midazolam, isoflurane, or aminophylline. Bispectral index values, rSO(2) using near-infrared spectroscopy, and hemodynamic parameters were recorded for 60 min.Results: Midazolam (0.05 mg center dot kg(-1)) significantly decreased the BIS from 47.8 +/- 5.4 to 35.0 +/- 4.5 at five minutes after injection (P < 0.001 vs control) during propofol anesthesia, whereas the rSO(2) was unchanged. Similarly, isoflurane (1.1% end-tidal) decreased the BIS from 42.5 +/- 7.5 to 27.8 +/- 6.9 (P < 0.001) without affecting rSO(2). In contrast, aminophylline (3 mg center dot kg(-1)) was associated with an increase in BIS from 41.6 +/- 2.1 to 48.3 +/- 9.2 at five minutes after injection (P < 0.05) without affecting rSO(2).Conclusions: Midazolam or isoflurane-induced decreases in the BIS during propofol anesthesia were not accompanied by a decrease in rSO(2). Aminophylline significantly increased the BIS score during propofol anesthesia, suggesting that aminophylline can antagonize, at least in part, the sedative actions of propofol.