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目的研究脑电双频指数(BIS)在小儿麻醉中的应用,为BIS在小儿临床麻醉上的广泛应用及提高小儿麻醉的安全性提供依据。方法 2011年1月-3月拟行腹部外科手术的患儿60例,男39例,女21例;年龄1～4岁,美国麻醉医师协会分级Ⅰ～Ⅱ级,随机分为两组,每组各30例。S组:七氟醚、瑞芬太尼和维库溴铵维持麻醉;P组:丙泊酚、瑞芬太尼和维库溴铵维持麻醉。采用BIS监测麻醉深度,将BIS控制在50±5,记录麻醉诱导前到手术探查期间不同时点的血流动力学参数及苏醒、拔管时间。结果手术过程中P组血压及心率明显低于麻醉前水平(P<0.05)。S组苏醒迅速、完全,苏醒时间与P组比较差异有统计学意义(P<0.05)。S组的血流动力学稳定性优于P组,苏醒时间、拔管时间相对较短。麻醉诱导前两组的BIS值均为97±1,意识消失时的BIS值为71±2。BIS值为50±5时,结果显示手术过程中(T4、T5、T6、T7)两组的心率、血压都很平稳。结论 BIS作为小儿麻醉镇静深度的监测指标有临床意义。
Objective To study the application of bispectral index (BIS) in pediatric anesthesia and provide the basis for the extensive application of BIS in pediatric clinical anesthesia and the improvement of pediatric anesthesia safety. Methods Sixty children (39 males and 21 females) undergoing abdominal surgery from January to March 2011 were enrolled in this study. The patients aged 1 to 4 years were divided into two groups according to the American Society of Anesthesiologists. Group of 30 cases. Group S: sevoflurane, remifentanil and vecuronium maintained anesthesia; group P: propofol, remifentanil and vecuronium maintained anesthesia. BIS was used to monitor the depth of anesthesia, and the BIS was controlled at 50 ± 5. The hemodynamic parameters and the time of recovery and extubation before anesthesia induction and at different time during surgical exploration were recorded. Results The blood pressure and heart rate of P group were significantly lower than those before anesthesia during operation (P <0.05). S group wake up quickly, completely, wake time and P group difference was statistically significant (P <0.05). The hemodynamic stability of S group was better than that of P group, recovery time and extubation time were relatively short. Before the induction of anesthesia, the BIS values of the two groups were both 97 ± 1, and the BIS value at the disappearance of consciousness was 71 ± 2. BIS value of 50 ± 5, the results show that during surgery (T4, T5, T6, T7) two groups of heart rate, blood pressure are very stable. Conclusions BIS has clinical significance as a monitoring indicator of sedation depth in pediatric anesthesia.