丙泊酚与咪达唑仑用于小儿腹股沟斜疝手术麻醉深度的BIS监测  

BIS monitoring value and anesthesia effects of propofol and midazolam in pedo -oblique inguinal hernia operation

作　　者：蔡军[1,2] 张永 陈虎[4] 周成华[1] 陆富钊[1] 周策[1] 李静[1] 胡倩[1] 刘璐[1] 武玉清[1] 

机构地区：[1]江苏省麻醉学重点实验室,江苏省麻醉与镇痛应用技术重点实验室,江苏徐州221004 [2]连云港市妇幼保健院麻醉科,江苏连云港222006 [3]徐州市第六人民医院泌尿外科,江苏徐州221006 [4]泗洪县人民医院普外科,江苏宿迁223800

出　　处：《徐州医学院学报》2012年第12期779-782,共4页Acta Academiae Medicinae Xuzhou

基　　金：基金项目：国家自然科学基金（81171013,81070889）;江苏省高校自然科学基金重大项目（10KJA320052）;江苏高校优势学科建设工程资助项目;江苏省青蓝工程优秀青年骨干教师资助项目

摘　　要：目的比较丙泊酚与咪达唑仑静脉麻醉用于小儿腹股沟斜疝手术时脑电双频指数（BIS）监测数值的变化和麻醉效果。方法选择行腹股沟斜疝择期手术的患儿40例，年龄2～6岁，ASA分级I～Ⅱ级，随机分为2组。咪达唑仑组（M组）静脉注射咪达唑仑0．1～0．2mg／kg，氯胺酮2mg／kg；丙泊酚组（P组）静脉注射丙泊酚2—2．5mg/kg，氯胺酮2mg／kg。分别记录并比较2组患儿麻醉诱导前（T1），麻醉诱导后（B），术中15min（L）、30min（T4）、45min（T5），手术结束时（T6）的平均动脉压（MAP）、心率（HR）、血氧饱和度（SpO2）、呼吸频率（RR）、BIS数值、术后苏醒时间以及术后并发症等情况。结果2组患儿麻醉诱导后的BIS值、MAP、HR均较诱导前降低，但P组下降更为明显，2组有明显差异（P〈0．05或P〈0．01）；2组患儿的RR、SpO2均较诱导前下降，但P组下降更为明显，P组RR在麻醉诱导后和术中15min显著低于M组（P〈0．01），SpO，在麻醉诱导后显著低于M组（P〈0．01）；P组患儿苏醒时间较M组显著缩短（P〈0．05）。结论应用丙泊酚进行小儿腹股沟斜疝手术麻醉，与咪达唑仑相比，BIS数值下降更明显，血流动力学更平稳，镇静充分，术后苏醒快。Objective To compare the effects of midazolam and propofol intravenous injection on bispectral index （BIS） and their anesthesia effects in pedo - oblique inguinal hernia operation. Methods Forty 2 - 6 years - old chil- dren undergoing pedo - oblique inguinal hernia surgery were randomly divided into 2 groups ： Midazolam group （ M, n = 20） and Propofol group （P, n =20）. We injected midazolam 0.1 -0.2 mg/kg and ketamine 2 mg/kg in group M. 2 - 2.5 mg/kg propofol and 2 mg/kg ketamine were given in group P. The figure of MAP, HR, Sp02, RR and BIS at the time of pro - anesthesia induction, 0 min, 15 min, 30 min, 45 min after anesthesia induction, and termination in surgery were recorded. The analepsia time and anesthesia complication of midazolam and propofol were compared. Results BIS, MAP, HR and analepsia time in group P was decreased significantly compared with those in group M after anesthe- sia induction （P 〈0.05 or P 〈0.01 ）. RR in group P was markedly reduded compared to that in group M at 0 min, 15 min after anesthesia induction （P 〈0.01 ）. SpO2 in group P was markedly decreased compared to that in group M at 0 min after anesthesia induction （ P 〈 0.01 ）. Conclusion Compared with midazolam, propofol provided a higher quality of sedation and smaller haemodynamics fluctuation in terms of pedo - oblique inguinal hernia operation and shorted theanalepsia time.

关 键 词：丙泊酚 咪达唑仑 脑电双频指数 小儿 腹股沟斜疝 麻醉 

分 类 号：R614.2[医药卫生—麻醉学]