目的:探讨脑电双频指数(BIS)监测在机械通气患者镇静深度评价中的价值。方法:选取15例机械通气患者,静脉注射咪唑安定达到SAS评分3~4分,持续或间断给药维持镇静深度,记录患者每2小时的SAS镇静分级评分及BIS,观察24小时。比较SAS评分与BIS值的相关性。计算BIS的敏感度和特异度,根据ROC曲线和BIS评价镇静深度的敏感度和特异度,寻找最适BIS值。结果:随镇静深度的加深,BIS明显降低,BIS与SAS评分呈正相关(r=0.662,P<0.05);SAS评分3~4分(镇静适度)时对应的BIS临界值为69.5~79。结论:BIS监测与SAS评分之间具有良好的相关性,能同步客观地监测机械通气患者的镇静深度,具有一定的临床诊断价值。
Citation:
ZHANG Chuan,LI Xiaojin,LI Xiaoyu,et al.. The Value of Bispectral Index Monitor in Assessing the Depth of Sedation of Ventilated Patients. West China Medical Journal, 2008, 23(1): 41-42. doi:
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Copyright © the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
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Berkenbosch J W,Fichter C R,Tobias J D.The correlation ofthe bispectral index monitor with clinical sedation scores duringmechanical ventilation in the pediatric intensive care unit[J].Anesth Analg,2002,94(3):506-511..
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- 1.
- 2. y ill adult[J].Crit Care Med,2002,30(1):119-141.
- 3. Lehmann A,KarzauJ,BoldtJ,et al.Bispectralindex-guided anesthesiain patients undergoing aortocoronary bypass grafting[J].Anesth Analg,2003,96:336-343.
- 4. Glass PS,Bloom M,Kearse L,et a1.Bislmetral analysis measur-sedation and me mory efects afpropofol,midasolam,isdlurane and alfentanil in healthy volunteers[J].Anesthesiology,1997,86(4):836-487..
- 5. Liu J,Sin H,White PF.Electr-ncephalogram bispectral analy-8i8 predicts the depth ofmidazolam-induced sedation[J].Anesthesiology,1996,84(1):64-69..
- 6. LeBlanc,J M,Dasta J F,Kane Gill S L,et al.Role of the bispectral index in sedation monitoring in the ICU.Ann-Pharmacother[J].2006,40(3):490-500.
- 7. NasrawaySASAJr,WuEC,KelleherRM,et al.How reliable is the Bispectral Index in critically ill patients?Aprospective,comparative,single blinded observer study[J].Crit Care Med,2002,30:1483-1487.
- 8. Ibrahim AE,Taraday JK,Khamseh ED.Bislmetml index monitoring during sedation with sevoflurane,midazolam,and propofol[J].Anesthesiology,2001,95(5):1151-1159..
- 9. Jacobi J,Fraser GL,Coursin DB,et al.Clinical practice guidelines for the sustained use of sedatives and analgesics in the criticall.
- 10. Ramsay MAE,Savage TM,Simpson BRJ,et a1.Controlled sedation with alphaxalone-alphadolone[J].Bri Med J,1974,2:656-659..
- 11. Simmons L E,Riker R R,Prato B S,et al.Assessing sedation during intensive care unit mechanical ventilation with the Bispectral Index and the Sedation-Agitation Scale[J].Crit Care Med,1999,27(8):1499-504.
- 12. 顾勤,刘宁,葛敏,等.脑电双频指数监测在重症加强治疗病房机械通气患者镇静中的应用[J].中国危重病急救医学,2007,19(2):101-103.
- 13. Berkenbosch J W,Fichter C R,Tobias J D.The correlation ofthe bispectral index monitor with clinical sedation scores duringmechanical ventilation in the pediatric intensive care unit[J].Anesth Analg,2002,94(3):506-511..