Conview麻醉深度监测仪监测右美托咪定镇静深度的可行性

Feasibility of Conview Anesthesia Depth Monitor in Monitoring Depth of Dexmedetomidine Sedation

摘要: 目的：评价Conview麻醉深度监测仪监测患者围术期右美托咪定镇静程度的准确性。方法：选择本院择期行膝关节手术的患者60例，性别不限，年龄50~80岁，ASA分级I或II级。术中使用警觉/镇静评分(OAA/S评分)、脑电双频指数(BIS)和Conview麻醉深度监测仪监测右美托咪定的镇静深度。选择L_2-3或L_3-4椎间隙进行穿刺，给予腰硬联合麻醉，调节麻醉平面在T₁₀-S₅。麻醉平面固定后，摆好手术体位，静脉泵注2 μg∙kg⁻¹∙h⁻¹右美托咪定15 min，之后泵注维持剂量0.75 μg∙kg⁻¹∙h⁻¹，直至手术结束前15 min停药。记录入室后的心率、血压、BIS值、Ai值作为基础值，记录即刻OAA/S评分。从输注右美托咪定开始直至手术结束，每10 min记录一次BIS值、Ai值、心率(HR)、血压(MAP)，记录完成后即刻进行OAA/S评分。结果：BIS值、Ai值与OAA/S评分有较高的相关性，均呈正相关。BIS值与AI值的相关系数是0.772 (P < 0.05)。BIS值、Ai值与OAA/S评分的相关系数分别是0.970、0.967 (P < 0.05)。OAA/S评分 ≥ 3分时，BIS值的最佳截断值为80，敏感度是95.8%，特异度是81.3%。Ai值的最佳截断值为82，敏感度是98.6%，特异度是81.7%。结论：Conview麻醉深度监测仪能准确地监测腰硬联合麻醉下右美托咪定的镇静深度，与BIS相比无明显差异，均能准确监测患者的镇静深度。

Abstract: Purpose: To evaluate the accuracy of Conview anesthesia depth monitor in monitoring the sedation degree of dexmedetomidine during perioperative period. Method: Select 60 patients with elective knee surgery in our hospital, regardless of gender, aged 50~80 years, ASA grade I or II. The depth of sedation of dexmedetomidine was monitored by vigilance/sedation score (OAA/S score), bispectral index (BIS) and Conview anesthesia depth monitor. Select L_2-3 or L_3-4 intervertebral space for punc-ture, give combined spinal epidural anesthesia, and adjust the anesthesia plane at T₁₀-S₅. After the anesthesia plane was fixed, the operation position was set, and dexmedetomidine 2 μg∙kg⁻¹∙h⁻¹ was injected intravenously for 15 minutes. Then, the pump was injected to maintain the dose of 0.75 μg∙kg⁻¹∙h⁻¹ until the drug was stopped 15 minutes before the end of the operation. Record the heart rate, blood pressure, BIS value and Ai value after entering the room as the basic value, and record the immediate OAA/S score. From the infusion of dexmedetomidine to the end of the operation, BIS value, Ai value, heart rate (HR) and blood pressure (map) were recorded every 10 minutes. OAA/S score was performed immediately after recording. Result: BIS value, Ai value and OAA/S score have high correlation, which are positively correlated. The correlation coefficient between BIS value and Ai value was 0.772 (P < 0.05). The correlation coefficients between BIS value, Ai value and OAA/S score were 0.970 and 0.967 respectively (P < 0.05). When OAA/S score ≥ 3, the best cut-off value of BIS value is 80, the sensitivity is 95.8%, and the specificity is 81.3%. The best cutoff value of Ai val-ue is 82, the sensitivity is 98.6%, and the specificity is 81.7%. Conclusion: Conview anesthesia depth monitor can accurately monitor the sedation depth of dexmedetomidine under combined spinal epidural anesthesia. There is no significant difference compared with BIS. It can accurately monitor the sedation depth of patients.