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Objective To observe the general anesthesia during the induction and intubation of bispectral index (Bispectral index, BIS) and hemodynamic changes in the law, and BIS values ??in the consciousness conversion trends; observed before extubation low dose of fentanyl to relieve the stress response and the BIS. (1) experimental: radical surgery of 50 patients with gastric cancer under general anesthesia. All patients herein are midazolam, propofol, fentanyl and vecuronium-induced intubation, intraoperative anesthesia was maintained propofol continuous infusion of remifentanil micro pump, intermittent isoflurane inhalation and intravenous vecuronium, the abdomen was stopped before isoflurane, the skin closure disable propofol and remifentanil. Surgery patients met extubation after extubation. Recorded before surgery (T 0 ), after induction before intubation 1min (T 1 ), intubation (T 2 ), intubation after 1min (T 3 ), 2min (the T 4 ), 3 min (T 5 ), 5min (, 6 ), mean arterial blood pressure (mean arterial pressure, MAP), heart rate (heart rate, HR) and BIS values; induction of general anesthesia, awakening during the conversion of consciousness: the loss of consciousness (Ta), surgery (Tb), recovery of consciousness (Tc), BIS values ??in the recovery room (Td). 2 experiment: randomly selected 50 cases of patients with radical gastrectomy under general anesthesia, fentanyl group (F, n = 50), an object-based experimental experimental control group (group C, n = 50). Maintain the same before induction of anesthesia, the abdomen was stopped before isoflurane, the skin closure disable propofol and remifentanil. Group F closure of the peritoneum, of intravenous fentanyl 1μg kg -1 ; C group received normal saline. Surgery patients met extubation after extubation observed before (T 0 ), before extubation 1min (T b1 ), after extubation 1min (T B2), 3 min (T b3 ), 10min (of T B4 ), mean arterial pressure (MAP), heart rate (HR) and BIS values ; preoperative, intraoperative blood sugar, respiratory function and awareness after extubation recovery. Results (1) experimental: ① induction of MAP, HR trends and BIS are basically the same, but the BIS changes late in the hemodynamic changes. MAP, HR at a intubation (T 2 ) began to rise after intubation 1min (T 3 ) is the most significant (P <0.05), 5 min after intubation (T The 6 ) close to the pre-intubation levels: no significant change in BIS values ??in T 2 , T 3 began to rise, T 4 the most significant (P <0.05). The ② anesthesia induced BIS values ??decreased gradually In the T0 when 95, TA 74; wake of BIS values ??upward trend, BIS values ??when Tc 77. Tb when BIS values ??the P 25 -P 75 69-76, when Tc the BIS values ??P 25 -P 75 72-80, at two points in time overlap. (2) Experiment II: All patients undergoing extubation period no difference in BIS values ??at each time point (P> 0.05). Fentanyl group after extubation 1min, 3min MAP, HR, blood glucose increase was significantly lower than the control group (P <0.01). Respiratory function and awareness recovery no difference between the two groups. Conclusion induction of general anesthesia during intubation BIS values ??and hemodynamic changes in trends similar, but BIS significantly delayed, predicting the induction of general anesthesia hemodynamic changes meaningless. 2 BIS values ??to determine the value of loss of consciousness in the consciousness of the conversion process is superior to recovery of consciousness. Anesthesia final small dose of fentanyl reduce to extubation reaction, without affecting the to extubation condition and BIS values.
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