熵指数和脑电双频指数用于脑瘫患儿七氟醚麻醉时镇静深度监测的评价  

Evaluation of entropy and bispectral index values for monitoring depth of sevoflurane anesthesia in children with cerebral palsy

作　　者：周丽萍[1] 贾乃光[1] 张亚军[1] 

机构地区：[1]中日友好医院麻醉科,北京100029

出　　处：《中日友好医院学报》2012年第4期202-204,207,共4页Journal of China-Japan Friendship Hospital

摘　　要：目的:通过熵指数和脑电双频指数(BIS)在脑瘫患儿七氟醚麻醉时与镇静深度的相关性和预测作用,评价熵指数和BIS用于脑瘫患儿镇静程度监测的准确性。方法:选择ASAⅠ或Ⅱ级、5～15岁择期在全身麻醉下行选择性周围神经缩窄术的脑瘫患儿25例。经面罩吸入5%七氟醚和N2O/O2:70%/30%。记录清醒时改良警觉/镇静评分(mOAAS)各阶段的反应熵(RE)、状态熵(SE)、BIS、无创血压(NIBP)、平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SPO2)。RE、SE、BIS与mOAAS评分的关系采用Spearman’s等级相关进行分析。计算RE、SE、BIS、MAP、HR、SPO2对镇静深度的预测概率。结果:脑瘫患儿RE、SE、BIS与mOAAS评分密切相关,明显优于MAP、HR、SPO2。RE、SE、BIS对镇静深度的预测概率(Pk)值明显高于MAP、HR、SPO2(P<0.01)。结论 :RE、SE、BIS均可以在脑瘫患儿七氟醚-笑气麻醉中反应镇静深度。Objective：To evaluate the accuracy of entropy and bispectral index（BIS）for monitoring depth of sevoflurane anesthesia in children with cerebral palsy.Methods：Twenty-five ASA Ⅰ or Ⅱ children aged 5-15 years undergoing elective surgery of peripheral neurotomy were enrolled in this study.Anesthesia were induced with 5% sevoflurane and 70% nitrous oxide in oxygen.Rresponse entropy（RE）,state entropy（SE）,BIS,non-invasive blood pressure（NIBP）,mean artery pressure（MAP）,heart rate（HR）and pulse oxygen saturation（SPO2）values in awake and each stage of mOAAS（modified Observer’s Assessment of Alertness/Sedation score）were recorded during the induction of anesthesia.The correlation between the different electroencephalographic indices（SE,RE and BIS）and mOAA/S were calculated by nonparametric Spearman’s rank-correlation analysis and analyzed with prediction probability（Pk）.Results：RE,SE and BIS were significantly better correlated with mOAA/S score than MAP,HR and SPO2 in children with cerebral palsy.The Pk values of RE,SE and BIS versus mOAA/S were significantly higher than that of MAP,HR and SPO2（P〈0.01）.Conclusion：Both entropy（SE,RE）and BIS can accrurately reflect the depth of sevoflurane anesthesia in children with cerebral palsy.

关 键 词：熵指数 脑电双频指数 脑瘫 预测概率 

分 类 号：R726.1[医药卫生—儿科]