脑电双频指数用于监测婴幼儿七氟醚麻醉深度的可行性

脑电双频指数用于监测婴幼儿七氟醚麻醉深度的可行性

陈丽丽,郑超,吕红,毛珍慧,张建敏,蔡晶晶

国家儿童医学中心首都医科大学附属北京儿童医院麻醉科,国家儿童医学中心首都医科大学附属北京儿童医院麻醉科,国家儿童医学中心首都医科大学附属北京儿童医院麻醉科,国家儿童医学中心首都医科大学附属北京儿童医院麻醉科,国家儿童医学中心首都医科大学附属北京儿童医院麻醉科,国家儿童医学中心首都医科大学附属北京儿童医院麻醉科

收稿日期:2017-08-15 修回日期:2017-08-15 出版日期:2017-09-25
基金资助:
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）

The Feasibility of Bispectral Index for Monitoring the Depth of Sevoflurane Anesthesia in Infants and Children

chenlili,zhen chao,lv hong,mao zhen hui,zhang jian min and cai jing jing

Department of Anesthesiology，Beijing Children's Hospital.Capital Medical University.National Center for Children's Health,Department of Anesthesiology，Beijing Children's Hospital.Capital Medical University.National Center for Children's Health,Department of Anesthesiology，Beijing Children's Hospital.Capital Medical University.National Center for Children's Health,Department of Anesthesiology，Beijing Children's Hospital.Capital Medical University.National Center for Children's Health,Department of Anesthesiology，Beijing Children's Hospital.Capital Medical University.National Center for Children's Health,Department of Anesthesiology，Beijing Children's Hospital.Capital Medical University.National Center for Children's Health

Received:2017-08-15 Revised:2017-08-15 Online:2017-09-25

摘要/Abstract

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(CETSev)，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(PETCO2)。结果：3组患儿的BIS差异有统计学意义，A组BIS在不同CETSev均低于B组、C组(P<0.01)；B组BIS在不同CETSev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CETSev浓度负相关。A组回归方程为Y(BIS)=54.742-8.914X(CETSev) (r=-0.431，P<0.01)；B组回归方程为Y(BIS)=77.528-12.684X(CETSev) (r=-0.689，P<0.01)；C组回归方程为Y(BIS)=88.863-14.395X (CETSev)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CETSev 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。

Abstract: 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) of 1.0 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 group Ⅱ (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 CETSev in all groups. The regression formula of group A was Y(BIS)=54.742-8.914X(CETSev) (r=-0.431，P<0.01)；the regression formula of group B was Y (BIS)=77.528-12.684X (CETSev) (r=-0.689， P<0.01)；the regression formula of group C was Y (BIS)=88.863-14.395X (CETSev) (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 sevoflurane concentration in three groups. BIS of infants and children aged 7 to 12 months old and 13 to 36 months old was well correlated with CETSev. BIS can be used to evaluate the depth of sevoflurane anesthesia. The effectiveness of BIS should be studied further for infants under 6 months.

陈丽丽,郑超,吕红,毛珍慧,张建敏,蔡晶晶. 脑电双频指数用于监测婴幼儿七氟醚麻醉深度的可行性[J]. .

chenlili,zhen chao,lv hong,mao zhen hui,zhang jian min and cai jing jing. The Feasibility of Bispectral Index for Monitoring the Depth of Sevoflurane Anesthesia in Infants and Children[J]. .

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