Clinical Study Of Cerebral State Index And Narcotrend Index On Sedation Depth Monitoring And Predictive Effect On Consciousness Recovery

0bjective To study the correlation among the cerebral state index(CSI)，Narcotrend index(NTI)，and predicted effect site concentration(Ce) duringdifferent state of consciousness in the anesthetic induction in the patientsundergoing laparoscopic cholecystectomy with target controlled infusion(TCI)of propofol，and to observe the abilities of CSI，NTI and NTS to response tothe stimulation of tracheal intubation，and also to evaluate and compare thepredictive effect of CSI，NTI and NTS on consciousness recovery during theemergence of general anesthesia after TCI of propofol and remifentanil.Methods Twenty-five classed ASA I or II patients aged27-67yearsundergoing laparoscopic cholecystectomy were anesthetized with TCI of propofol.the propofol infusion was set at Ce of0.5ug／ml in the beginning and increasedprogressively by0.5ug／ml every4min until the modified OAA／S values ofzero．The values of CSI，NTI and Ce of propofol at LVC and LOC of the patientswere recorded. The values of CSI and NTI to response to the stimulation oftracheal intubation were recorded. The values and the prediction probability(Pk)of CSI，NTI，NTS，Ce，MAP and HR were recorded and compared during the periodof non－reaction to the stimulation，at the time of eyes opening and orientationrecovery.Results The values of CSI，NTI and Ce have a good linear correlation with0AA／S，the correlation coefficients (r) were0.925，0.933，-0.953respectively(P<0.01). The prediction probability (Pk)were0.90±0.03，0.91±0.03，0.92±0.04respectively，compared with Pk=0.5，P<0.01. The values of CSI at LVC andLOC were68.4±5.9and59.5±6.7，while NTI were72.3±6.3and63.1±7.5，theCe of propofol were (1.96±0.45)ug／ml and (2.38±0.48)ug／ml respectively.Regression equation between CSI and Ce was CSI=96.2-15.33Ce (R2=0.85)，andbetween NTI and Ce was NTI=97.6-14.12Ce (R2=0.88)，and between CSI and NTI wasCSI=0.88NTI+3.5(R2=0.83).The values of CSI，NTI and NTS were not significant changes after tracheal intubation．There were significant differences for CSI，NTI，NTS and Ce at different state of consciousness during anesthesia emergence，the correlation coefficients (r) were0.89，0.92，-0.86respectively (P<0.01).Pkvalue of CSI，NTI，NTS and Ce in predicting non-reaction to the stimulation toeyes opening，non-reaction to the stimulation to orientation recovery，and eyesopening to orientation recovery were more than0.8and significantly higher than0.5and Pk values of them were not significant differences(P>0.05).Conclusions During target controlled infusion of propofol，there is a goodlinear correlation among CSI，NTI and Ce of propofol.The values of CSI，NTI andCe can reflect the sedation level of propofol. Although there is a significantcorrelation between CSI and NTI，a deviation does exist in a certain range; CSI，NTI and NTS can not reflect the stimulation of tracheal intubation，but theycould be used for predicting patients consciousness recovery effectively duringthe emergence of general anesthesia after TCI of propofol and remifentanil．...