小儿脊柱侧弯矫正术应用丙泊酚对脑电双频指数的影响  

Influence of propofol anesthesia on the bispectral index during adolescent scoliosis surgery

作　　者：白宁[1] 宋宇龙[1] 秦秦[1] 兰自侃[1] 

机构地区：[1]陕西省人民医院麻醉科,陕西西安710068

出　　处：《第四军医大学学报》2007年第16期1488-1490,共3页Journal of the Fourth Military Medical University

摘　　要：目的:观察丙泊酚麻醉下小儿脊柱侧弯矫正术中脑电双频指数(BIS)的变化.方法:38例脊柱侧弯后路矫正术患儿根据术中麻醉药的不同随机分为两组:Ⅰ组(丙泊酚组,n=18),Ⅱ组(异氟醚组,n=20).记录两组麻醉前(T0),诱导后5min(T1),插管后5min(T2),切皮(T3),停药即刻(T4),唤醒时(T5),术毕(T6),拔管前(T7),拔管后(T8)各点平均动脉血压(MAP),心率(HR)及脑电双频指数(BIS)值.结果:麻醉前、插管前后、切皮、术毕、拔管后两组MAP,HR,BIS值相近(P>0.05).而唤醒期间、拔管前MAP,HRⅡ组高于Ⅰ组(P<0.05).BIS值插管前后、切皮、唤醒停药时、术毕低于麻醉前(P<0.05),而唤醒即刻、拔管后接近麻醉前水平(P>0.05).两组比较唤醒即刻、拔管前后等各时间点无统计学差异(P>0.05).唤醒时间Ⅰ组较Ⅱ组短(P<0.05),唤醒成功人数Ⅰ组较Ⅱ组多(P<0.05),对唤醒有记忆的人数及术后恶心呕吐发生率Ⅰ组低于Ⅱ组(P<0.05).结论:丙泊酚用于脊柱侧弯矫正术,可缩短唤醒时间,术中血流动力学稳定,躁动、对唤醒有记忆及恶心呕吐发生率较低.BIS在唤醒试验中监测麻醉深度,能预测术中唤醒患者的指令运动反应.AIM： To observe the change of bispectral index （BIS） during propofol anesthesia in the adolescent scoliosis surgery. METHODS： Thirty-eight cases of scoliosis children were divided into 2 groups at random according to different anesthetics ： propofol group, n = 18; isoflurane group, n =20. Mean arterial pressure（MAP）, heart rate（HR）and BIS in the 2 groups were recorded at the time of preanesthesia（T0 ）, 5 min after induction （ T1 ）, 5 min after intubation（ T2 ） , skin incision （ T3 ） , medica- tion withdrawal （ T4 ） , arousing （ T5 ）, operation ending （ T6 ） , preextubation （ T7 ） and postextubation （ T8 ）. RESULTS ： The MAP,HR and BIS of the 2 groups were similar at the time of pre- anesthesia, intubation, skin-incision, operation ending and postextubation （P 〉 0.05 ）. The MAP and HR of isoflurane group was significantly higher than those of propofol group at the time of arousing and preextubation （ P 〈 0.05 ）. The BIS of pre- and post- intubation, skin-incision, medication withdrawal, arousing and operation ending were siginificantly lower than that of prean- esthesia （P 〈 0.05 ）. But at the time of arousing, postextubation, BIS was similar to that of preanesthesia （P 〉0.05 ）. The BIS was not significantly different between the 2 groups during anesthesia （ P 〉 0.05 ）. The arousing time of propofol group was significantly shorter than that of isoflurane group （ P 〈 0. 05 ）. The aroused people of propofol group were much more than the ones of isoflurane group （P 〈 0.05 ）. The number of people who remembered at awaking and the incidence of postoperative nausea and vomitng in propofol group were significantly lower than those in isoflurane group （ P 〈 0.05 ）. CONCLUSION ： Propofol anesthesia in the adolescent scoliosis surgery can shorten the arousing time, keep the hemedynamics stable, relieve the restlessness, decrease the incidences of bad memories at arousing and postoperative nausea and vomiting. By BIS mon

关 键 词：脊柱侧凸/外科学 二异丙酚 脑电双频指数 

分 类 号：R743.4[医药卫生—神经病学与精神病学]