脑电双频指数评估小儿斜疝术后镇静恢复程度的可行性

目的 通过对学龄前期与学龄期小儿斜疝手术的脑电双频指数(BIS)监测,评估镇静恢复程度并为安全返回病房提供指导.方法 接受小儿斜疝手术患儿40例,按学龄前期(3～5岁)和学龄期(6～12岁)分为Ⅰ组和Ⅱ组,每组各20例.术中用丙泊酚微泵注射保持镇静,行小儿骶管阻滞之前调整注射速度直到警觉,镇静(OAA/S)评分≤1分.术后重点监测恢复过程中生命体征和BIS,同时由专人评估OAMS评分.结果Ⅰ组和Ⅱ组患儿从意识消失到清醒期间BIS的中位数逐渐增大,BIS>76时预测患儿镇静恢复的灵敏度和特异度分别为Ⅰ组94%和50%,Ⅱ组100%和100%. Ⅰ组和Ⅱ组受试者工作特征曲线下面积分别为0.917±0.007和0.955±0.004.结论 BIS是监测小儿麻醉镇静深度的良好指标,在判断小儿镇静恢复程度方面有良好的指导意义.

Evaluating the role of bispectral index in assessing the depth of sedation in hypogastrie operation of children

Objective To evaluate the role of bispectral index (BIS) in assessing the depth of sedation in hypogastric operation of children. Methods Forty children undergoing hypogastric operation were divided into two groups with 20 cases each by pre-school (age 3-5) (Ⅰ group) and school (age 6-12)(Ⅱ group). Sedation was solely maintained with TCI propofol. The infusion was adjusted till adequate scdation (OAA/S≤ 1 score) before sacral block. The course of propofol infusion and BIS of recovery period were closely observed. Sedation scores were assessed by special anesthetists. Results During recovery period, the mean values of BIS were gradually increased, when BIS > 76 predicted 94% sensitivity and 50% specificity in Ⅰ group, 100% sensitivity and 100% specificity in Ⅱ group. ROC area under the curve of the two groups were 0.917 ± 0.007, 0.955 ± 0.004. Conclusions BIS can predict fairly well the level of consciences during recovering periods. BIS monitoring is an effective and reliable method to guide children recovery.