摘要
目的探讨BIS在脑瘫患儿选择性脊神经后根切断术(selective posterior rhizotomy,SPR)后镇静深度监测中的应用价值及最佳区间。方法以新疆医科大学第二附属医院2016年1月至2016年12月收治的43例脑瘫患儿为研究对象,Spearman相关性分析评价BIS与Ramsay评分的相关性,绘制受试者工作特征(receiver operator characteristic,ROC)曲线确定术后镇静监测的BIS最佳区间。再选取2017年2月至2019年4月收治的82例脑瘫患儿,按随机数表法分为观察组与对照组,各41例。观察组SPR术后镇静时将BIS值维持在55~72,对照组将Ramsay评分维持在2~4分。比较观察组与对照组的镇静情况(镇静不足、镇静满意、镇静过度的占比)、不良反应发生率(非计划拔管率、肺炎、谵妄)。结果脑瘫患儿SPR术后的BIS值与Ramsay评分呈显著负相关(r=-0.923,P<0.01),BIS最佳数值区间为55~72。观察组镇静过度发生率(4.88%)明显低于对照组(19.51%)(P<0.05)。两组患者非计划拔管、肺炎、谵妄发生率的差异无统计学意义(P>0.05)。结论脑瘫患儿SPR术后的BIS最佳区间为55~72,术后镇静过程中将BIS控制在该区间有利于降低镇静过度发生率。
Objective This study aims to explore the application value and optimal interval of bispectral index(BIS)in sedation depth monitoring after selective posterior rhizotomy(SPR)in children with cerebral palsy.Methods Forty-three children with cerebral palsy were enrolled in the Second Affiliated Hospital of Xinjiang Medical University from January 2016 to December 2016.The correlation between BIS and Ramsay score was analyzed by Spearman correlation.The receiver operating characteristic(ROC)curve was plotted to determine the optimal BIS interval for postoperative sedation monitoring.A total of 82 children with cerebral palsy were enrolled from February 2017 to April 2019.They were divided into an observation group and a control group according to the random number table method,41 cases each.The BIS value was maintained at 55-72 in the observation group after SPR sedation,and the Ramsay score was maintained at 2-4 points in the control group.The sedation(insufficient sedation,satisfactory sedation,excessive sedation),incidence of adverse reactions(unplanned extubation rate,pneumonia,delirium)were compared between two groups.Results There was a significant negative correlation between BIS and Ramsay scores after SPR in children with cerebral palsy(r=−0.923,P<0.01).The optimal BIS range was 55-72.The incidence of excessive sedation was 4.88%in the observation group,which was significantly lower than the 19.51%incidence of excessive sedation in the control group(P<0.05).There was no significant difference in the incidence of unplanned extubation,pneumonia,and delirium between the two groups(P>0.05).Conclusions The best BIS interval after SPR in children with cerebral palsy is 55-72.Controlling BIS in this interval during postoperative sedation is beneficial to reduce the incidence of excessive sedation.
作者
陈爱芳
袁应川
许宜珍
戴安卢
Chen Aifang;Yuan Yingchuan;Xu Yizhen;Dai Anlu(Department of Anesthesiology,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;Department of Anesthesiology,the Second International Medical Center Affiliated to Zhejiang University School of Medicine,Hangzhou 310026,China)
出处
《国际麻醉学与复苏杂志》
CAS
2020年第7期651-654,共4页
International Journal of Anesthesiology and Resuscitation
基金
新疆维吾尔自治区科技厅面上项目(2018D01C238)。
