作者单位：100730首都医科大学附属北京同仁医院麻醉科通信作者：王惠军（E-mail：wang3020@163.com）BIS对OSAS患者经鼻清醒盲探气管插管镇静程度的评估王惠军纪芳【摘要】目的探讨脑电双频指数（BIS）评价阻塞性睡眠呼吸暂停综合征（OSAS）患者经鼻清醒盲探气管插管镇静程度的可靠性。方法选择30例Malampati试验=3\*ROMANIII～=4\*ROMANIV级的OSAS患者，无重要器官器质性疾病，行悬雍垂腭咽成形术（uvulopalatopharyngiplasty，UPPP）。插管前给予患者咪唑安定、芬太尼，直至镇静评分（OAA/S）为3分时，然后经鼻腔盲探插管，记录用药前后及插管前后心率（HR）、平均动脉压（MAP）、脉搏氧饱和度（SpO2）、BIS和OAA/S评分变化。结果患者BIS值随镇静深度加深而下降，且与OAA/S评分下降一致，镇静后BIS值与OAA/S评分5分时相比有显著性差异；血液动力学参数HR，MAP随OAA/S评分由5分降为3分而逐渐下降，与镇静前相比有显著性差异；经鼻插管后BIS，HR，MAP均上升，与OAA/S评分3分时相比有显著性差异，插管前后SpO2均无显著性差异，镇静后均能耐受盲探插管操作，术后随访患者对插管过程无记忆。结论BIS参数能准确反映OSAS患者的镇静深度，当BIS值76-85，OAA/S评分3分时的镇静深度适宜行OSAS患者经鼻清醒盲探气管插管。【关键词】脑电双频指数；阻塞性睡眠呼吸暂停综合征；镇静；清醒经鼻盲探气管插管EvaluateSuitableSedativeDepthofobstructivesleepapneasyndromeforconsciousblindnasotrachealintubationbyBispectralindexWANGHui-jun,JIFang【Abstract】ObjectiveToevaluatetherelibilityofobstructivesleepapneasyndrome（OSAS）patientssuitablesedativedepthforconsciousblindnasotrachealintubationbyBispectralindex（BIS）.MethodsThirtycasesofOSASpatientswithMalampatitest=3\*ROMANIII～=4\*ROMANIV,withoutcriticalorganparenchymaldisease,withUvulopalatopharyngoplasty(UPPP).ThepatientswereadministeredfentanylandmidazolambyveinuntilthescoreofOAA/Sdroppedtothree,thenforblindnasotrachealintubation.TorecordthenumbersofBP,MAP,SpO2,BISandOAA/Sbeforeadministeringdrugs,aftermedication,beforeintubationandafterachievingintubation.ResultThevaluesofBISdroppedwiththedeepeningofsedation,andaccordedtothedropofOAA/S,andasignificantdifferencewasobservedcomparedwithbeforesedation.TheirHR,MAPalsodroppedwiththedroppingofOAA/S,andasignificantdifferencewasobservedcomparedwithbeforesedation.ThevaluesofBIS,HR,MAPofthepatitentshadasignificantascendafterintubation,andasignificantdifferencewasobservedcomparedwiththescoreofOAA/Sdroppedtothree,SpO2ofbothgroupsconsistentlymaintainedinnormalrange,Thepatitentscantolerancetheprocessoftheblindtrachealintubationafterasuitablesedation.Thepatitentshadnoremembranceinfollowingupofpost-operation.ConclusionBISwas