Extremely low bispectral index value during robotic-assisted laparoscopic prostatectomy: A case report.
Extremely low bispectral index value during robotic-assisted laparoscopic prostatectomy: A case report.
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DOI：
10.4103/sja.sja_659_21
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发表时间：
2022-04
影响因子：
1.2
通讯作者：
Hoshi, Takuo
中科院分区：
文献类型：
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作者：
Hoshi, Takuo
手术过程中的头低脚高位和气腹可能会影响颅内压和脑氧合，进而影响脑电双频指数（BIS）值。长时间保持头低脚低体位和气腹可能损害脑血管的自动调节。我们介绍了一例在机器人辅助腹腔镜直肠癌切除术（RALP）中BIS值极低的患者。我们在全身麻醉下对患者进行了管理，手术开始后6小时，他的BIS值显著降低。脑电图（EEG）的抑制率（SR）也降低，表明大脑活动减少。解除头低脚高位后BIS值迅速升高，麻醉终止。患者痊愈，无任何神经功能缺损，出院。头低位和气腹可引起脑电图异常。
The steep Trendelenburg position and pneumoperitoneum during surgery may affect intracranial pressure and cerebral oxygenation, which in turn may affect the values of the bispectral index (BIS). Prolonged maintenance of the Trendelenburg position and pneumoperitoneum may impair cerebrovascular autoregulation. We present a case of a patient with an extremely low BIS value during robotic-assisted laparoscopic prostatectomy (RALP). We managed the patient under general anesthesia and he showed a prominent decrease in BIS values 6 h after the start of surgery. Suppression ratio (SR) of electroencephalography (EEG) is also decreased, suggesting that the brain activity decreased. The BIS value increased quickly after the Trendelenburg position was released and the anesthesia was terminated. The patient recovered without any neurological deficits and was discharged. Steep Trendelenburg position and pneumoperitoneum can cause EEG abnormalities.