观察脑电双频指数(bispectral index，BIS)监测对门诊无痛人工流产术患者麻醉过程及恢复的意义。

将2008年6月至2008年10月上海市第一妇婴保健院门诊择期在丙泊酚–舒芬太尼静脉麻醉下行无痛人工流产术的门诊患者180例，随机分为BIS监测组(Ⅰ组，n＝90)与常规监测组(Ⅱ组，n＝90)(本研究遵循的程序符合上海市第一妇婴保健院人体试验委员会所制定的伦理学标准，得到该委员会批准，分组征得受试对象的知情同意，并与之签署临床研究知情同意书)。静脉给予枸橼酸舒芬太尼5 μg、丙泊酚1.0 mg/kg负荷量后，丙泊酚维持量Ⅰ组根据脑电双频指数(40～55)调节，Ⅱ组仅根据患者临床体征调节。分别测定T₀(注药时)，T₁(睫毛反射消失时)，T₂(扩张宫颈时)，T₃(刮宫时)，T₄(退扩阴器完毕时)和T₅(麻醉苏醒时)5个时点两组患者的平均气道压(mean arterial pressure，MAP)、心率(heart rate，HR)、动脉血氧饱和度(pulse oxygen saturation，SpO₂)和脑电双频指数。记录丙泊酚用量、术中反应、手术时间及留院观察时间等。

两组一般资料及麻醉前平均气道压、心率、动脉血氧饱和度、脑电双频指数比较，差异无显著意义(P>0.05)。人工流产术中两组丙泊酚用量及术后留院观察时间比较，Ⅰ组明显少于或短于Ⅱ组，且差异有显著意义(P<0.01)。在T₁和T₂时点，两组患者平均气道压均下降，但Ⅰ组降幅大于Ⅱ组，且差异有显著意义(P<0.01)。术后不良反应发生率比较，Ⅰ组明显少于Ⅱ组，且差异有显著意义(P<0.01)。

脑电双频指数监测用于门诊人工流产术的麻醉，对预防麻醉药用量不足或逾量，减轻血流动力学改变，避免术中肢动与知晓，意义重大，有利于提高麻醉安全性，减少并发症。

To evaluate the process and significance of bispectral index(BIS) monitoring in out-patients who underwent artificial abortion under propofol-sufentanil anesthesia.

From June to October 2008, 180 patients who were underwent selective artificial abortion under propofol-sufentanil anesthesia were randomly divided into regular monitoring+ BIS monitoring group (group Ⅰ, n=90) and regular clinical monitoring group (group Ⅱ, n=90). Informed consent was obtained from all participates. In group Ⅰ, the maintenance dose of propofol infusion were adjusted to achieve a target bispectral index of 40~55. In group Ⅱ, propofol dose adjustments were made based only on standard clinical signs. The mean airway pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO₂) and bispectral index were detected at T₀ (at giving drug), T₁(loss of eyelash reflex), T₂(cervical dilatation), T₃(dilatation and curettage), T₄(withdrawl vaginal speculum), T₅(at analepsia) of two groups. The dosage of propofol, intraoperative response, duration of operation and recovery parameters were recorded.

There were no significant differences between two groups of general clinical information, mean airway pressure before anaesthesia, heart rate, pulse oxygen saturation, and bispectral index monitoring (P>0.05). The dosage of propofol and duration of postoperative stay in hospital were significantly less and shorter in group Ⅰ than those of group Ⅱ(P<0.01), so did the decrease of mean airway pressure at T₁ and T₂ (P<0.01). And there also had significant difference of incidence of adverse reactions between two groups(P<0.01).

Titrating propofol with bispectral index monitoring during intravenous anesthesia for artifical abortion in chinic could prevent propofol under or over dose, decrease the change of haemodynamics, avoid limb movement, keep hemodynamics stable and make recovery quicker.