摘要： 目的 比较相同最低肺泡有效浓度（MAC）的地氟烷和七氟烷对全身麻醉下肩关节镜手术中脑电双频指数（BIS）和手术体积描记指数（SPI）的影响。方法 采用前瞻性随机对照研究，将择期行肩关节镜手术的80例患者随机分为地氟烷组（D组）和七氟烷组（S组），每组40例。麻醉诱导前，所有患者均行肌间沟臂丛神经阻滞。麻醉维持采用1.0 MAC地氟烷或七氟烷持续吸入，通过BIS监测吸入麻醉药的镇静程度，通过SPI监测镇痛程度。记录腔镜置入前（T₁）、腔镜置入时（T₂）、滑膜切除或清创时（T₃）、缝合切口时（T₄）的BIS、SPI值。结果 在T₁~T₂时，D组与S组相比，BIS值的差异无统计学意义（P > 0.05）；在T₃~T₄时，与S组相比，D组BIS值显著降低，差异有统计学意义（P < 0.05）。与S组相比，D组在T₁~T₄时SPI值显著降低，差异有统计学意义（P < 0.05）。结论 相同MAC地氟烷和七氟烷的BIS、SPI不同，提示地氟烷、七氟烷的镇静、镇痛效能不同。

地氟烷和七氟烷对肩关节镜手术中脑电双频指数和手术体积描记指数的影响

杨丽, 王媛媛

中国医科大学附属第四医院麻醉科, 沈阳 110032

收稿日期:2021-07-19出版日期:2022-03-30发布日期:2022-03-16
通讯作者:王媛媛E-mail:shetao1220@hotmail.com
作者简介:杨丽(1989-),女,医师,硕士.



关键词: 最低肺泡有效浓度, 地氟烷, 七氟烷, 脑电双频指数, 手术体积描记指数, 肩关节镜手术
Abstract: Objective To compare the effects of desflurane and sevoflurane at an equal minimum alveolar concentration(MAC) on the bispectral index(BIS) and surgical pleth index(SPI) in arthroscopic shoulder surgery under general anesthesia. Methods In this prospective, randomized, controlled study, 80 patients scheduled for arthroscopic shoulder surgery were randomly distributed into desflurane (group D,n=40) and sevoflurane(group S,n=40) groups. All patients received pre-operative interscalene brachial plexus block. General anesthesia was maintained with desflurane or sevoflurane at 1.0 MAC throughout the study period. The BIS and SPI were used to estimate the degree of hypnosis and analgesia during the surgical procedure, respectively, and recorded at predefined time points, including T₁ (before portal insertion), T₂(during portal insertion), T₃(during synovectomy and debridement), and T₄(during wound closure at the end of surgery). Results There was no significant difference in BIS values at T₁ to T₂ between the groups D and S(P > 0.05). The BIS values at T₃ to T₄ and SPI values at T₁ to T₄ in group D were significantly lower compared with those in group S, respectively (P < 0.05). Conclusion Sevoflurane and desflurane at an equal MAC did not produce similar BIS and SPI values, indicating that they might have different hypnotic or analgesic potencies.
Key words: minimum alveolar concentration, desflurane, sevoflurane, bispectral index, surgical pleth index, arthroscopic shoulder surgery
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