脑电双频指数评估小儿术后镇静深度的可行性  

Role of bispectral index in assessing depth of sedation in postoperative children

作　　者：纪均[1] 黄慧敏[1] 姜虹[1] 朱也森[1] 

机构地区：[1]上海交通大学医学院第九人民医院麻醉科,上海200011

出　　处：《上海交通大学学报（医学版）》2007年第2期218-220,共3页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的 研究脑电双频指数（BIS）评估小儿口腔颌面外科术后镇静深度的可行性。方法　42例6～12岁口腔颌面外科术后丙泊酚维持镇静下带管自主呼吸的患儿。每4小时和需要吸痰时分别运用Ramsay评分和气管吸痰评分（TSS）评估镇静深度，同时记录BIS值。就BIS值与镇静评分间进行相关分析；计算BIS判断镇静深度的敏感度和阳性预测值。结果　BIS值与对应的Ramsay和TSS评分呈显著负相关（r分别为-0．71和-0．44，P均〈0．01）。BIS值为85时，其区别镇静不足和镇静充分的敏感度为0．84和0．81，阳性预测值为0．66和0．79；BIS值为65时，区别镇静充分和镇静过度的敏感度为0．67和0．65。阳性预测值为0．39和0．21。结论　对于术后丙泊酚维持镇静下带管自主呼吸的患儿，BIS值与Ramsay和TSS评分有良好的相关性，并能可靠而有效区分镇静不足和镇静充分。Objective To evaluate the role of bispectral index （BIS） in assessing the depth of sedation after oral and maxillofacial operations in children. Methods BIS values, Ramsay sedation scores and tracheal suctioning scores （TSS） of 42 postoperative pediatric patients aged between 6 to 12 years administrated propofol for sedation were recorded. All patients recovered spontaneous breathing but still kept tracheal intubator. BIS values were compared with simultaneously obtained clinical sedation scores. Sensitivity and positive predictive value of BIS were calculated to determine the role of BIS in assessing the depth of sedation. Results BIS value was negatively correlated with the related Ramsay sedation score and TSS （r = -0.71 and -0.44, respectively; P 〈 0.01 for both）. To differentiate adequate from inadequate sedation, a BIS value as 85 had a sensitivity of 0.81 and 0.84 and a positive predictive value of 0.66 and 0.79. To differentiate adequate from excessive sedation, a BIS value as 65 had a sensitivity of 0.65 and 0.67 and a positive predictive value of 0.21 and 0.39. Conclusion For pediatric patients maintaining sedation with propofol, BIS value well correlates with Ramsay and TSS scores. BIS monitoring is an effective and reliable method to differentiate adequate from inadequate sedation.

关 键 词：脑电双频指数 镇静 RAMSAY评分 气管吸痰评分 儿童 

分 类 号：R726.1[医药卫生—儿科]