腦雙頻譜指數在改良電休克治療中的應用_《華西醫學》

作者：

劉婧 , 龍偉 ,  王儒蓉

四川大學華西醫院麻醉科（成都，610041）;

關鍵詞：

腦雙頻譜指數改良電休克治療丙泊酚動作發作時間

DOI：

10.7507/1002-0179.20130171

視頻：

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目的　探討在丙泊酚誘導麻醉的改良電休克治療中腦雙頻譜指數(BIS)與動作發作時間的關系，以及其他因素對電休克動作發作時間的影響。方法　2012年4月－5月，記錄28名患者的107次治療中的不同時刻腦雙頻譜指數（BIS）值誘導前、睫毛反射消失時、治療前即刻、動作發作結束即刻、動作發作結束后60 s）、麻醉藥物劑量、動作發作時間及治療不良反應，并根據動作發作時間將治療分為A組（治療無效組，動作發作時間＜17 s）和B組（治療有效組，動作發作時間≥17 s）。探討不同時刻BIS值與癲癇發作時間的關系并比較A、B組之間BIS值、麻醉藥物劑量差異。結果　兩組間睫毛反射消失時及治療前即刻BIS值差異有統計學意義（P＜0.05）。動作發作時間與治療前即刻BIS值呈正相關（r=0.245，P=0.012），與治療次數呈負相關（r=?0.283，P=0.004）。結論　治療前即刻BIS值與動作發作時間呈正相關，因此，此時的BIS值也許可以作為預測動作發作時間長短的指標。

引用本文： 劉婧,龍偉,王儒蓉. 腦雙頻譜指數在改良電休克治療中的應用. 華西醫學, 2013, 28(4): 533-536. doi: 10.7507/1002-0179.20130171 復制

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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.
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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. 　姜瑋, 任艷萍, 湯宜朗, 等. 改良電休克治療中麻醉藥和肌松藥的使用種類和劑量[J]. 中國心理衛生雜志, 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, 吳新民, 羅艾倫, 等. 摩根臨床麻醉學[M]. 4版. 北京: 人民衛生出版社, 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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腦雙頻譜指數在改良電休克治療中的應用

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