摘要
目的:探讨脑电双频指数(BIS)用于婴幼儿七氟醚麻醉深度监测的可行性。方法:随机选取择期全麻手术的患儿60例,按月龄分为3组:A组(1~6个月,n=20)、B组(7~12个月,n=20)和C组(13~36个月,n=20)。3组均给予8%七氟醚诱导,逐步调节七氟醚呼气末浓度(C_(ET)Sev),分别维持在最低肺泡有效浓度1.0 MAC(Ⅰ组);0.75MAC(Ⅱ组)和0.5 MAC(Ⅲ组)至少15min,随后记录BIS、HR、SBP、DBP、RR和呼气末二氧化碳(P_(ET)CO_2)。结果:3组患儿的BIS差异有统计学意义,A组BIS在不同C_(ET)Sev均低于B组、C组(P<0.01);B组BIS在不同C_(ET)Sev低于C组(P<0.01);随七氟醚呼气末浓度从1.0 MAC降至0.5 MAC,A组Ⅲ组BIS高于Ⅰ组、Ⅱ组(P<0.05)。B组、C组的Ⅱ组、Ⅲ组BIS明显高于Ⅰ组(P<0.01);Ⅲ组BIS明显高于Ⅰ组、Ⅱ组(P<0.01)。患儿的BIS均与C_(ET)Sev浓度负相关。A组回归方程为Y(BIS)=54.742-8.914X(C_(ET)Sev)(r=-0.431,P<0.01);B组回归方程为Y(BIS)=77.528-12.684X(C_(ET)Sev)(r=-0.689,P<0.01);C组回归方程为Y(BIS)=88.863-14.395X(C_(ET)Sev)相关性(r=-0.714,P<0.01),A组相关性低于B组与C组。结论:七氟醚全麻时,3组患儿BIS与C_(ET)Sev呈一定剂量的负相关,7~12个月和13~36个月患儿BIS相关性较好,BIS可用于七氟醚麻醉深度的监测,6月龄以下婴儿使用BIS的有效性还有待进一步研究。
Objective： To evaluate the validation of bispectral index（ BIS） monitoring in infants and children anesthetized with sevoflurane. Methods： Sixty patients undergoing elective surgery（ ASAⅠor Ⅱ） under general anesthesia were divided into 3 groups of A（ 1 to 6 months old,n = 20）,B（ 7 to 12 months old,n = 20） and C（ 13 to 36 months old,n = 20）. Anesthesia was induced with 8% sevoflurane via facemask. The end-tidal sevoflurane concentration was gradually adjusted to maintain at the minimum alveolar concentration（ MAC） of1. 0 MAC,0. 75 MAC and 0. 5 MAC at least 15 min; and then BIS values and other parameters were recorded. Results： BIS increased gradually and significantly in three groups. At different end-tidal sevoflurane concentration,the BIS values were lower in group A than those in group B and group C（ P〈0. 01）; the BIS values were lower in group B than those in group C（ P〈0. 01）. As end-tidal sevoflurane concentration decreased from 1. 0 MAC to 0. 5 MAC,the BIS values were higher in group Ⅲ of group A than those in group Ⅰ and groupⅡ（ P〈0. 05）; BIS of group B and group C increased significantly（ P〈0. 01）. The linear regression analysis showed a significant negative correlation between BIS and CET）Sev in all groups. The regression formula of group A was Y（ BIS） = 54. 742-8. 914 X（ CET）Sev）（ r =-0. 431,P〈0. 01）; the regression formula of group B was Y（ BIS） = 77. 528-12. 684 X（ CET）Sev）（ r =-0. 689,P〈0. 01）; the regression formula of group C was Y（ BIS） = 88. 863-14. 395 X（ CET）Sev）（ r =-0. 714,P〈0. 01）,The correlation was lower in group A compared with that in group B and group C. Conclusion： During sevoflurane anesthesia,BIS negative correlates with end-tidal sevofluraneconcentration in three groups. BIS of infants and children aged 7 to 12 months old and 13 to 36 months old was well correlated with CET） Sev. BIS can be used to evaluate the depth of sevoflurane anesthesia. The effectiveness of B
出处
《中国医药导刊》
2017年第9期905-908,共4页
Chinese Journal of Medicinal Guide
基金
首都临床特色应用研究与成果推广项目(项目编号:Z161100000516142
项目名称:BIS调控麻醉深度对脊柱侧弯手术临床转归的研究)
关键词
脑电双频指数
婴幼儿
七氟醚
Bispectral index
Infants and children
Sevoflurane
