Clinical Application Of BIS During Single Lung Ventilation In Thoracic Surgery And The Influence Of Different BIS Values On Stress Response

Objective:To study the clinical application of BIS in thoracic surgery and the influence of different anesthesia depth under BIS monitoring during single lung ventilation on stress response of patients undergoing thoracoscopic lobectomy.Methods:A total of 60 patients（n=60）who underwent thoracoscopic lobectomy during the period from September 2018 to May 2019 were selected and randomly divided into 3groups according to the number random table method,with 20 patients in each group（n=20）.Group A in the experimental group maintained deep anesthesia,namely BIS（Bispectral index）:36-45,Group B in the experimental group maintained moderate anesthesia BIS:46-55,and Group C in the control group did not undergo BIS monitoring.The changes of heart rate（HR）,mean arterial pressure（MAP）,stress indexes cortisol（Cor）and blood glucose（Glu）before anesthesia induction（T0）,immediately after one-lung ventilation（T1）,60 min after one-lung ventilation（T2）and immediately after skin suture（T3）in the three groups were compared.Results:Glu（6.35±0.56,7.04±0.26,6.17±0.54）,Cor（191.13±46.0,283.25±30.07,183.01±19.71）at times T1,T2,T3 in group C are higher than Glu（5.28±0.49,5.34±0.49,5.40±0.47）,Cor（142.75±31.45,181.36±19.62、153.81±33.92）,at times T1,T2,T3 in group A,and Glu（5.63±0.35、6.06±0.19、5.79±0.44）、Cor（168.45±31.16,171.09±25.28,159.39±18.77）at T1,T2,T3 in Group B were significantly higher（P<0.05）.However,compared with group B,groupA only had difference in Cor at T1（p<0.05）.The HR and MAP of group A and C at T1,T2 and T3 are all different from that of time T₀（p<0.05）,while the HR and MAP of group B at T1 and T2 are different from that of time T0（p<0.05）.Moreover,the MAP at T1,T2 and T3 in group A（69±5,67±6,75±7）is lower than that in group B（80±8,79±4,84±9）at T1,T2 and T3（p<0.05）.Conclusion:BIS anesthesia depth monitoring should be performed during one-lung ventilation during thoracic surgery and maintained at 46⁵5,which can not only inhibit the stress response but also have a slight effect on hemodynamics.