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目的:通过观察脑电双频指数(BIS)用于经皮心导管介入封堵小儿室间隔缺损手术麻醉深度的监测,评价其对小儿先天性室间隔缺损介入术麻醉的影响。方法:择期行先天性室间隔缺损封堵术患儿60例,随机分为BIS监测组(A组,30例)和警觉/镇静评分组(B组,30例)。记录麻醉诱导前、诱导后1 min、手术开始时、术中、术毕、患儿苏醒时各时点患儿心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO2),记录丙泊酚用量,需要辅助呼吸的例数、时间,患儿苏醒时间、术后有无恶心呕吐及呼吸抑制。结果:60例患儿麻醉效果均满意,两组HR、MAP、SpO2相比,均无统计学差异(P>0.05);A组术中呼吸抑制的例数、辅助呼吸时间、患儿苏醒时间、丙泊酚用量均明显少于B组(P<0.05);术后两组患儿均无恶心呕吐及呼吸抑制。结论:在小儿室间隔缺损封堵术中应用BIS监测可正确判断麻醉深度,使术中患儿呼吸循环稳定,静脉全麻药物用量明显减少,患儿苏醒时间明显缩短,提高了麻醉质量,具有较高的安全性和可行性。
OBJECTIVE: To evaluate the effect of interventional anesthesia on the depth of anesthesia in pediatric patients with ventricular septal defect treated by interventional transcatheter arterial ventilation (BIS). Methods: Sixty children with congenital ventricular septal defect were randomly divided into BIS monitoring group (A group, 30 cases) and vigilance / sedation score group (B group, 30 cases). The changes of heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO2) and blood pressure were recorded before anesthesia induction, 1 minute after induction, at the beginning of surgery, Record the amount of propofol, the number of cases requiring assisted breathing, time, recovery time in children, postoperative nausea and vomiting and respiratory depression. Results: There was no significant difference in HR, MAP and SpO2 between the two groups (P> 0.05). A group of patients with respiratory depression, assisted breathing time, , And the dosage of propofol were significantly less than those in group B (P <0.05). No nausea, vomiting and respiratory depression were found in both groups. Conclusion: The application of BIS monitoring in children with ventricular septal defect closure can correctly determine the depth of anesthesia, intraoperative respiratory cycle stability, intravenous general anesthesia drugs significantly reduce the recovery time was significantly shortened children, improve the quality of anesthesia, with Higher safety and feasibility.