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Changes in the Bispectral Index in Response to Loss of Consciousness and No Somatic Movement to nociceptive stimuli in Elderly Patients

引用

Chinese Medical Journal 2016年第4期129卷 410-416页

作者： Ning Yang Yun Yue Jonalhan Z Pan Ming-Zhang Zuo Yu Shi Shu-Zhen Zhou Wen-Ping Peng Jian-Dong Gao Department of Anesthesiology Beijing Chao-Yang Hospital Capital Medical University Beijing 100020 China Department of Anesthesiology Beijing Hospital Beijing 100730 China Department of Anesthesiology and Perioperative Care Brain and Spinal Injury Center University of California San Francisco CA 94110 USA

Background： Bispectral index （BIS） is considered very useful to guide anesthesia care in elderly patients, but its use is controversial for the evaluation of the adequacy of *** study compared the BIS changes in response to loss of consciousness （LOC） and loss of somatic response （LOS） to nociceptive stimuli between elderly and young patients receiving intravenous target-controlled infusion （TCI） of propofol and ***： This study was performed on 52 elderly patients （aged 65-78 years） and 52 young patients （aged 25-58 years）, American Society of Anesthesiologists physical status Ⅰ or Ⅱ.Anesthesia was induced with propofol administered by TCI.A standardized noxious electrical stimulus （transcutaneous electrical nerve stimulation, [TENS]） was applied （50 Hz, 80 mA, 0.25 ms pulses for 4 s） to the ulnar nerve at increasing remifentanil predicted effective-site concentration （Ce） until patients lost somatic response to *** in awake, prestimulus, poststimulus BIS, heart rate, mean arterial pressure, pulse oxygen saturation, predicted plasma concentration, Ce of propofol, and remifentanil at both LOC and LOS clinical points were ***： BISLOC in elderly group was higher than that in young patient group （65.4 ＆#177; 9.7 vs.57.6 ＆#177; 12.3）（t =21.58, P 〈 0.0001） after TCI propofol, and the propofol Ce at LOC was 1.6 ＆#177; 0.3 μg/ml in elderly patients, which was significantly lower than that in young patients （2.3 ＆#177; 0.5 μg/ml）（t =7.474, P 〈 0.0001）.As nociceptive stimulation induced BIS to increase, the mean of BIS maximum values after TENS was significantly higher than that before TENS in both age groups （t =8.902 and t =8.019, P 〈 0.0001）.With increasing Ce of remifentanil until patients lost somatic response to TENS, BISLOS was the same as the BISLOC in elderly patients （65.6 ＆#177; 10.7 vs.65.4 ＆#177; 9.7）, and there were no marked differences between elderly and young patient groups in BISawake, BISLOS, and Ce o

关键词： Bispectral Index Elderly nociceptive stimuli Propofol Remifentanil

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