中文摘要：

目的研究熵指数用于判断七氟烷麻醉时的体动反应并与双频谱指数比较。方法ASAⅠ～Ⅱ级择期腹部手术患者22例，按切皮有无体动反应分为体动组（9例）和非体动组（13例）。入室后常规监测，采用异丙酚、琥珀胆碱、芬太尼快诱导气管插管，持续吸入七氟烷，维持呼气末七氟烷浓度为1．0MAC，15min后开始手术，切皮前不用神经肌肉阻滞剂，如果发生体动，则按10％提高下一个患者七氟烷呼气末浓度，如果不动则按10％降低下一个患者七氟烷呼气末浓度。每例患者同时行两种脑电监测于以下时点记录数据：入室、切皮前60s、前30s、切皮后45s、后120s。结果熵指数值在两组之间有统计学差异（P〈0．05），双频谱指数值在两组之间无统计学差异（P〉0．05）。反应熵和状态熵判断切皮有体动的截断值是76、75，相应的灵敏度／特异度是89％／91％、88％／92％；反应熵和状态熵判断切皮无体动的截断值是65、64，相应的灵敏度／特异度是88％／90％、89％／91％。结论熵指数可以用于七氟烷麻醉时体动反应有无的判断。

英文摘要：

Objective To investigate if the spectral entropy including response entropy （RE） and state entropy （SE） can predict movement at skin incision during sevoflurane anesthesia and to compare it with bispectral entropy （BIS）. Methods Twenty-two ASA Ⅰ - Ⅱ patients undergoing elective abdominal surgery were studied. They were allocated into movement group and non-movement group according to their response to skin incision. Anesthesia was induced with propofol, succinylcholine and fentanyl（iv）. After intubation, sevoflurane was inhaled and end-tidal concentration was maintained at 1.0MAC for 15min, then operation was begun without neuromuscular blockers. Sevoflurane end-tidal concentration was increased by 10% or decreased by 10% for the next patient when movement was detected or not detected. Each patient was simultaneously monitored with spectral entropy and BIS. Data were recorded at following time points： baseline values, 60s and 30s before skin incision, 45s and 120s after skin incision. Results No statistical difference was found in BIS index between the two groups （ P 〉 0.05） but a statistical difference was observed in entropy index between two groups （P 〈 0.05）. RE and SE had threshold values of 76 and 75 with sensitivity/specificity of 89%/91% and 88%/92% for movement at skin incision respectively; RE and SE had threshold values of 65 and 64 with sensitivity/specificity of 88%/90% and 89%/91% for non-movement at skin incision respectively. Conclusion Entropy index can predict movement at skin incision during sevoflurane anesthesia.