脑双频谱指数在改良电休克治疗中的应用_《华西医学》

作者：

刘婧 , 龙伟 ,  王儒蓉

四川大学华西医院麻醉科（成都，610041）;

关键词：

脑双频谱指数改良电休克治疗丙泊酚动作发作时间

DOI：

10.7507/1002-0179.20130171

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　探讨在丙泊酚诱导麻醉的改良电休克治疗中脑双频谱指数(BIS)与动作发作时间的关系，以及其他因素对电休克动作发作时间的影响。方法　2012年4月－5月，记录28名患者的107次治疗中的不同时刻脑双频谱指数（BIS）值诱导前、睫毛反射消失时、治疗前即刻、动作发作结束即刻、动作发作结束后60 s）、麻醉药物剂量、动作发作时间及治疗不良反应，并根据动作发作时间将治疗分为A组（治疗无效组，动作发作时间＜17 s）和B组（治疗有效组，动作发作时间≥17 s）。探讨不同时刻BIS值与癫痫发作时间的关系并比较A、B组之间BIS值、麻醉药物剂量差异。结果　两组间睫毛反射消失时及治疗前即刻BIS值差异有统计学意义（P＜0.05）。动作发作时间与治疗前即刻BIS值呈正相关（r=0.245，P=0.012），与治疗次数呈负相关（r=−0.283，P=0.004）。结论　治疗前即刻BIS值与动作发作时间呈正相关，因此，此时的BIS值也许可以作为预测动作发作时间长短的指标。

引用本文： 刘婧,龙伟,王儒蓉. 脑双频谱指数在改良电休克治疗中的应用. 华西医学, 2013, 28(4): 533-536. doi: 10.7507/1002-0179.20130171 复制

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1. 　Ding ZN, White PF. Anesthesia for electroconvulsive therapy[J]. Anesth Analg, 2002, 94 (5): 1351-1364.
2. 　Eranti SV, Mogg AJ, Pluck GC, et al. Methohexitone, propofol and etomidate in electroconvulsive therapy for depression: a naturalistic comparison study[J]. J Affect Disord, 2009, 113(1-2): 165-171.
3. 　Tan HL, Lee CY. Comparison between the effects of propofol and etomidate on motor and electroencephalogram seizure duration during electroconvulsive therapy[J]. Anaesth Intensive Care, 2009, 37(5): 807-814.
4. 　Gazdag G, Kocsis N, Tolna J, et al. Etomidate Versus Propofol for electroconvulsive therapy in patients with schizophrenia[J]. J ECT, 2004, 20(4): 225-229.
5. 　Erdil F, Demirbilek S, Begec Z, et al. Effects of propofol or etomidate on QT interval during electroconvulsive therapy[J]. J ECT, 2009, 25(3): 174-177.
6. 　Avramov MN, Husain MM, White PF. The comparative effects of methohexital, propofol, and etomidate for electroconvulsive therapy[J]. Anesth Analg, 1995, 81(3): 596-602.
7. 　Bauer J, Hageman I, Dam H, et al. Comparison of propofol and thiopental as anesthetic agents for electroconvulsive therapy: a randomized, blinded comparison of seizure duration, stimulus charge, clinical effect, and cognitive side effects[J]. J ECT, 2009, 25(2): 85-90.
8. 　姜玮, 任艳萍, 汤宜朗, 等. 改良电休克治疗中麻醉药和肌松药的使用种类和剂量[J]. 中国心理卫生杂志, 2011, 25 (11) : 835-839.
9. 　Geretsegger C, Nickel M, Judendorfer B, et al. Propofol and methohexital as anesthetic agents for electroconvulsive therapy: a randomized, double-blind comparison of electroconvulsive therapy seizure quality, therapeutic efficacy, and cognitive performance[J]. J ECT, 2007, 23(4): 239-243.
10. 　Cohen Y, Feldinger E, Ogorek D, et al. Increased propofol requirement during succeeding administrations for electroconvulsive therapy[J]. J Clin Anesth, 2004, 16(4): 282-285.
11. 　岳云, 吴新民, 罗艾伦, 等. 摩根临床麻醉学[M]. 4版. 北京: 人民卫生出版社, 2007: 123-125.
12. 　Nishihara F, Saito S. Pre-ictal bispectral index has a positive correlation with seizure duration during electroconvulsive therapy[J]. Anesth Analg, 2002, 94(5): 1249-1252.
13. 　Gombar S, Aggarwal D, Khanna AK, et al. The bispectral electroencephalogram during modified electroconvulsive therapy under propofol anesthesia: relation with seizure duration and awakening[J]. J ECT, 2011, 27(2): 114-118.
14. 　Dahaba AA. Different conditions that could result in the bispectral index indicating an incorrect hypnotic state[J]. Anesth Analg, 2005, 101(3): 765-773.
15. 　Thimmaiah R, Thirthalli J, Ramesh VJ, et al. Effect of a course of electroconvulsive therapy on interictal bispectral index values: a prospective study[J]. J ECT, 2012, 28(1): 20-23.

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脑双频谱指数在改良电休克治疗中的应用

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《华西医学》

脑双频谱指数在改良电休克治疗中的应用

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