脑电双频指数在不同年龄患儿丙泊酚复合瑞芬太尼静脉麻醉中的临床观察

目的 探讨丙泊酚复合瑞芬太尼静脉麻醉中脑电双频指数在不同年龄患儿中的影响.方法 ASA Ⅰ或Ⅱ级伞麻插管手术的患儿40例,根据年龄分为4组,每组10例.A组≤3月;B组3个月～≤2岁;C组2岁～≤6岁;D组6岁～≤12岁.观察丙泊酚3 mg/kg,瑞芬太尼1μg/kg诱导,丙泊酚6 mg·kg-1·h-1、瑞芬太尼0.25 μg·kg-1·h-1持续静脉输入期间,记录诱导前(T1)、诱导后(T2)、插管时(T3)、切皮时(T4)、停药时(T5)、自主呼吸恢复(T6)和拔管时(T7)的脑电双频指数(BIS)值及镇静评分;记录自主呼吸恢复和气管拔管的时间.结果 (1)4组在T2、T3、T4、T5和T6时BIS值下降明显(P<0.01),T1时BIS恢复到诱导前水平.(2)4组患儿自主呼吸恢复时间差异无统计学意义.A组与B、C、D组拔管时间相比差异有统计学意义(P<0.01),时间明显延长,B、C、D组的拔管时间明显缩短.(3)T1时,所有忠儿的儿童镇静评分(UMSS评分)为0～1分,T1时的UMSS评分为4分,T7时UMSS评分为0～1分.结论 在不同年龄儿童丙泊酚复合瑞芬太尼静脉麻醉巾使用脑电双频指数可以更加有效监测麻醉深度.

Effectiveness of bispectral index in intravenous anesthesia with remifentanil and propofol in children

Objective To investigate the effectiveness of bispectral index(BIS) during intravenous anesthesia with remifentanil and propofol in children. Methods Forty ASAI or Ⅱ pediatric patients undergoing selective surgery were divided into 4 equal groups according to age: Group A (≤3 m), Group B(>3 m -2 y), Group C (2 -6 y), and Group D (6 - 12 y). In all groups, anesthesia was induced with before induction (T1), after induction (T2), at intubation (T3), at skin incision (Ta), at stopping of anes the tics (T5), at spontaneous respiration (T6), and at extubation (T7). The time between stopping anesthetics and spontaneous respiration and the time of extubation were recorded respectively. Results (1)The BIS values at T2, T3, T4, T5, and T6 were lower compared with that at T1 in all groups(all P <0.01).(2) There was no significant difference in the spontaneous respiration recovery time among all groups. The extubation time of Group A was much longer than those of Groups B, C, and D (all P < 0.01) . (3) The UMSS scores at T1 and T7 in all groups were all lower than those at T3. Conclusion BIS effectively monitors the depth of intravenous anesthesia with remifentanil and propofol.