Using EEG-BIS and HRV to Evaluate the Effects of Patient-Controlled Sedation During Thyroidectomy Under Regional Anesthesia<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /> 王 晖Wang Hui, 温 洪Wen Hong, 岳 云Yue Yun. Department of Anesthesia, Beijing Red Cross Chaoyang Hospital, Affiliated Capital University of Medical Sciences, Beijing 100020, China. ABSTRACT Objective:To evaluate the effect of patient-controlled sedation(PCS) and doctor-controlled sedation(DCS) during thyroidectomy under regional anesthesia using bispectral index (BIS) and heart rate variability (HRV). Methods:Forty patients of ASAⅠ~Ⅱ undergoing thyroidectomy with regional anesthesia were randomly divided into PCS group (n=20) and DCS group (n=20). Loading dose of 0.75μg/kg fentanyl and 40μg/kg droperidol was administrated before operation for both groups. Then PCS was performed in PCS group and a half dose of Innovar (0.1mg fentanyl and 5mg droperidol) was given at a interval of 30min in DCS group.BP,HR,ECG, RR and BIS,HRV were continuously monitored. Results:There were no significant differences in BIS,HRV and HR between PCS group and DCS group. However, a significant decreasing of BIS occured 10 min earlier in PCS group than in DCS group. HRV decreased markedly 30 min after administration of drugs for both groups. No severe sedation and respiratory depression were found, and the quality of sedation was the same in both groups. Conclusion:Evaluated with BIS and HRV, there was little difference between PCS and DCS groups during thryoidectomy with regional anesthesia. Key words:Patient-controlled sedation; Doctor-controlled sedation; Bispectral index; Heart rate variability; Fentanyl; Droperidol 病人自控镇静(PCS)是指局麻手术中,病人按照自己的需求控制微电脑泵给药,以求得最适宜的镇静、松弛状态。本研究利用脑电双频谱指数(BIS)和心率变异性(HRV)作为客观参数,从镇静程度和对伤害性刺激的自主反应程度两个方面来评价PCS的临床效果,同时与医生控制镇静(DCS)法进行比较,报道如下。 |