Effects Of Common Opioids On Bispectral Index And Auditory Evoked Potential Index Under General Anesthesia

In recent years, with the development of Anesthesiology, especially the new opioid analgesic drugs emerging, brought new problems of anesthetic management， including the definition and monitoring the depth of anesthesia is the key to these problems, which is to improve the level of anesthesia management, improve the quality of anesthesia has important influence. Currently known, opioids influence on the depth of anesthesia, there are many reports, has made certain progress, gained some experience, but mainly concentrated in the inhalation anesthesia (such as sevoflurane inhalation), study its effect under intravenous anesthesia, report less. On this premise, this study through the choice of opioid agonist antagonist dezocine, Bhutto butorphanol and commonly used opioid receptor agonist fentanyl, sufentanil respectively in clinical application of propofol target controlled infusion for general anesthesia (TCI) in the process, to explore the opioid analgesics common influence on the bispectral index and auditory evoked potential index, thus to provide reference for rational use of opioid anesthesia drugs.Part one:Effects of different opioids with equivalent-dose on depth of anesthesia during Anesthesia with Target-Controlled Infusion of PropofolObjective:To investigate the efficacy of different opioids with equivalent-dose on hemodynamic state and the Bispectral index(BIS)、the auditory evoked potential index(AAI) when combined with propofol TCI in patients.Methods:100patients were randomly divided into5groups (n=20each):All patients were induced with propofol.After the loss of conscience,0.6mg/kg rocuronium was injected intravenous,intubation was carried out. Anesthesia was maintained by TCI of propofol3～4μg/ml.According to the BIS and AAI values to adjust propofol dosage to maintain the AAI value in the range of15-40and BIS value in the range of40～60.These opioids were administered intravenously15min after the tracheal intubation.Mean arterial blood pressure (MAP),heart rate (HR), bisspectral index (BIS) and auditory evoked potential index (AAI) were recorded as baseline value at15min after the tracheal intubation.MAP, HR, BIS and AAI were measured at3-min after the intubation up to30min.Results:Compared with group N,BIS and AAI were significantly increased at T2～T5in group D (P<0.05);Compared with group F,BIS in group D was increased at T2and T5(P<0.05),BIS in group B was increased at T3and T4(P<0.05);AAI in group D was significantly increased at T2～T5(P<0.05);Compared with group S,BiS in group D was increased at T2and T5(P<0.05),BIS in group B was increased at Tsand T4(P<0.05);AAI in group D was increased at T1～T5(P<0.05),AAI in group B was increased at T4and T5(P<0.05).Compared with group To,BIS and AAI in group D and group B were significantly increased at T2～T5(P<0.05).Conclusion:Under the propofol anesthesia,equivalent dose fentanyl and sufentanil can maintain a stable hemodynamic state and affect little in BIS and AAI,then have no effect on the judgement of depth of anesthesia; equivalent dose dezocine and butorphanol can maintain a stable hemodynamic state,but can increase BIS and AAI value under the propofol anesthesia, then affect the judgement of depth of anesthesia.Part two:Effects of different doses of dezocine on depth of anesthesia during Anesthesia with Target-Controlled Infusion of PropofolObjective:To investigate the efficacy of different doses of dezocine on hemodynamic state and the Bispectral index(BIS)、the auditory evoked potential index (AAI)when combined with propofol TCI in patients.Methods:80patients were randomly divided into4groups (n=20each):0.05mg/kg dezocine group (group D1),0.1mg/kg dezocine group (group D2),0.15mg/kg dezocine group (group D3), control group (fentanyl, group F). All patients were induced with propofol.After the loss of conscience,0.6mg/kg rocuronium was injected intravenous,intubation was carried out.Anesthesia was maintained by TCI of propofol3～4μg/ml.According to the BIS and AAI values to adjust propofol dosage to maintain the AAI value in the range of15～40and BIS value in the range of40～60. These opioids were administered intravenously15min after the tracheal intubation. Mean arterial blood pressure (MAP),heart rate (HR), bisspectral index (BIS) and auditory evoked potential index (AAI) were recorded as baseline value at15min after the tracheal intubation.MAP, HR, BIS and AAI were measured at3-min after the intubation up to30min.Results:Compared with F group, D1group after administration of MAP, HR, BIS and AAI increased,(P<0.05), but no significant difference between D3group after administration of MAP, BIS, AAI relative to the F group at different time points (P>0.05), group D2and group D1after the administration of each time point changes with no difference; comparison of T0, D1group HR, MAP, BIS and AAI increased significantly, the difference was statistically significant (P<0.05), D2group, BIS HR relative values and AAI values increased significantly, the difference was statistically significant (P<0.05), D3group and no difference in T2-T5at MAP, BIS, AAI relative value T0change (P>0.05).Conclusion:There was a correlation between dezocine and the depth of anesthesia during propofol general anesthesia in patients, dezocine can maintain a stable hemodynamic state and cause a increase in BIS and AAI,then affect the judgement of depth of anesthesia.At the same time,dezocine combined with propofol for maintenance of anesthesia is feasible,can achieve the depth of anesthesia effectively.