目的:评估脑电双频指数(BIS)监测用于小儿全麻复合用药的作用。方法选择我院2014年1月~2014年12月小儿外科泌尿系手术患儿80例,麻醉方式为气管内插管吸入麻醉,采用数字表随机法分为两组:术中均采用 BIS 监测,观察组40例术中根据预设理想的 BIS 值调整用药量,对照组麻醉医生不能观察 BIS 监测结果,根据临床经验结合常规监测调节用药量,记录两组患者术中/术末平均动脉压(MAP)、心率(HR)、呼末七氟烷浓度、BIS 值和七氟烷用量,并比较两组苏醒、拔管、出麻醉后监测治疗室(PACU)平均时间。结果两组患儿术中/术末 MAP、术末 HR 比较差异无统计学意义(P >0.05);观察组术中 HR 明显低于对照组,术中、术末呼末七氟烷浓度明显小于对照组,术中、术末 BIS值明显低于对照组(P <0.05)。观察组患儿平均七氟烷用量明显低于对照组,患儿苏醒、拔管、出 PACU 平均时间均短于对照组(P <0.001)。观察组恶心呕吐发生率为2.50%,明显低于对照组(χ2=4.507,P =0.034)。结论小儿全麻应用 BIS 监测可使麻醉药物用量更加精确,从而缩短苏醒时间,提高安全性,为小儿外科的大力发展提供有力的麻醉保障。
Objective To evaluate the role of bi-spectral index (BIS)monitoring playing on combined drug use during pediatric general anesthesia. Methods Chose 80 cases undergoing surgery at Department of Pediatric Urinary Surgery at our hospital January 2014 ~ December 2014,intra-tracheal intubation inhalation anesthesia was used for pediatric anesthesia.A random number table was used to divide all the into two groups:BIS monitoring were used during the operation,40 cases of the observation group received adjusting dosage of anesthetic drugs according to the preset ideal BIS value;but for the control group,the anesthetist was forbidden observing BIS monitoring results,and adjusted dosage of anesthetic drugs according to clinical practice experience combined with routine monitoring.Recorded the two groups’patients intra- and end-surgery mean arterial pressure (MAP),heart rate (HR),end-expiratory Seven halothane concentration,BIS value and Seven halothane dosage,and compared between the two groups the average time of recovery,of extu-bation,and of discharge from PACU. Results Group - paired comparison of intra - and end - surgery MAP,end-surgery HR showed no statistical difference (P > 0.05);patients in the observation group had significantly lower HR than the control group,and intra-and end-surgery end-expiratory Seven halothane concentration in the observation group was lower than those in the control group,intra-and end-surgery BIS values in the observation group were significantly lower than those of the control group (P <0.05).In the ob-servation group,the pediatric patients had lower average Seven halothane use than those of the control group, the pediatric patients of the observation group had shorter average recovery time,shorter average time of extu-bation,shorter average time discharge from PACU than those of the control group (P <0.001 ).The inci-dence of nausea and vomiting was 2.50% in the observation group which was significantly lower than that of the control group (χ2 =4.507,P =0.034). Conclusion The application of BIS monitoring in pediatric anes-thesia can make anesthetic drug dosage more accurate,so can shorten the recovery time and can improve the safety of anesthesia,which provides powerful anesthetic guarantee for the vigorous development of pediatric.