Combined monitoring of intracranial pressure and bispectral index in patients with severe craniocerebral trauma after operation

Abstract

Objective To investigate the value of bispectral index and intracranial pressure monitoring in evaluation of postoperative consciousness and short-term prognosis in patients with severe traumatic brain injury. Methods A simple random sampling method was used in 30 cases of brain trauma coma patients in the People′s Hospital of Northern Jiangsu Province from January 2014 to December 2014. Glasgow coma scale(GCS) were evaluated at intervals of 8 hours, GCS were recorded for 3 days after surgery, The bispectral index value and intracranial pressure value are recorded at the same time. According to GCS, the patients were divided into two groups, group A (3≤GCS≤5) and group B(5<GCS≤8). The 21-days natural survival rate was counted. The Kaplan-Meier Method and Log-rank test were used to analyze the relationship between Bispectral index and intracranial pressure. Results The bispectral index value of group A was 45.3±3.8, the intracranial pressure value of group A was (18.6±2.8) mmHg, The bispectral index value of group B was 32.2±8.2, the intracranial pressure value of group B was (33.4±4.6) mmHg. The 21-days survival rate of group A was 55%, and 21-days survival rate of group B was 30%. The Spearman rank correlation method was used to analyze the values. Bispectral index value was positively correlated with coma degree after operation in patients with severe traumatic brain injury, and was negatively correlated with intracranial pressure value (r=0.532, P<0.05; r=0.521, P<0.05). The more severer the patient′s craniocerebral injury, the more severer the condition, the higher the intracranial pressure, the lower the bispectral index value, the worse the prognosis is. Conclusion Combined monitoring of bispectral index and intracranial pressure has high application value in evaluating the coma degree and prognosis of patients with severe craniocerebral injury after operation. Key words: Craniocerebral trauma; Intracranial pressure; Prognosis; Bispectral index; Monitoring