脑电双频指数监测在小儿射频消融术中的应用

我院心脏儿科2005至2008年择期行心导管射频消融术患儿106例，随机分为脑电双频指数（BIS）监测组（A组，50例）和改良警觉镇静（OAA／S）评分组（B组，56例），按需以靶控输注丙泊酚维持麻醉。A组维持BIS值55～65；B组以改良OAA／S评分1分控制麻醉深度。分别于麻醉诱导前、诱导后1min、术中、术毕时，测定心率、平均动脉压（MAP）、脉搏血氧饱和度（SpO2），记录丙泊酚用量、辅助呼吸时间、清醒时间及术后有无恶心呕吐和呼吸抑制。结果示两组心率、MAP、SpO2差异无统计学意义（P〉0．05），术中辅助呼吸时间、丙泊酚用量及清醒时间较短（P〈0．05），两组术后均无恶心呕吐及呼吸抑制。提示应用脑电双频指数监测在小儿射频消融术中能正确判断麻醉深度，可保持患儿呼吸循环平稳，减少麻醉药用量，缩短术后清醒时间，提高麻醉质量。

The application of Bispectrai index in pediatric radio frequency catheter ablation

The aim of the study is to evaluate the feasibility and safety of Bispectral index (BIS) monitoring in pediatric radio frequency catheter ablation. One hundred and six children aged 0. 6-12 years, scheduled for radio frequency catheter ablation, were randomly divided into two groups. In group A patients received BIS monitoring during the operation (n = 50), and the group B received modified Observer's Assessment of Alertness/Sedation (OAA/S) scaling (n = 56). The anesthesia was maintained with propofol target-controlled infusion. The intraoperative propefol target concentration was adjusted to maintain the BIS values between 55-65 in group A and OAA/S scale about 1 in group B respectively, The heart rate (HR), mean arterial pressure (MAP) and pulse oximetric saturation (SpO2) were measured before anesthetic induction, 1 min after induction, catheter puncturing and the end of operation respectively. The requirements of propofol, the times of supporting ventilation and recovery, the respiratory depression, nausea and vomiting postoperatively were also recorded. The intraoperative HR, MAP and SpO2 showed no differences between two groups, but the requirements of pmpofol, the times of supporting ventilation and recovery were less in group A than that of group B (P<0.05). All children didn't have nausea, vomiting and respiratory depression. The results suggest that in pediatric radio frequency catheter ablation, BIS monitoring has the advantages of timely adjustment of anesthetic depth, reducing anesthetic requirements, shortening the time of recovery, so as the perioperative safety can be improved.