脑电双频指数麻醉深度监测在小儿心内直视手术中的应用  

Application of bispectral index for anesthesia depth monitoring to pediatric open-heart operation

作　　者：庞宏宣[1] 林高翔[1] 张文斌[1] 石泉[1] 唐娟[1] 

机构地区：[1]桂林医学院附属医院麻醉科,广西桂林541001

出　　处：《华夏医学》2012年第6期821-823,共3页Acta Medicinae Sinica

基　　金：广西壮族自治区卫生厅自筹经费科研项目(Z2007195)

摘　　要：目的:探讨脑电双频指数(BIS)在小儿心内直视手术麻醉中的临床应用价值。方法:实施心内直视手术60例患者,随机分成3组:非BIS组,停跳组和不停跳组。其中停跳组和不停跳组手术中应用脑电双频指数(BIS)麻醉深度监测指导麻醉药量。设立观测点为麻醉前(T0)、气管插管后5min(T1)、切皮时(T2)、体外循环开始后2min(T3)、鼻温谷值(T4)、停机后5min(T5)、手术结束时(T6)的血流动力指标CVP、MAP、HR,停跳组和不停跳组同时记录BIS值。结果:使用BIS监测麻醉深度的停跳组和不停跳组比非BIS组血流动力学更稳定(P<0.05),停跳组和不停跳组比较血流动力学变化无显著性差异(P>0.05)。结论:在BIS监测指导下麻醉用药控制麻醉深度,血流动力学更稳定,BIS监测指导麻醉用药在停跳和不停跳心内直视手术都可获得安全满意的麻醉深度。Objective： To investigate the clinica application of bispectral index （BIS） to pediatric open-heart operation anesthesia. Methods： 60 patients performed open heart operation were randomly divided into three groups： the non-BIS, heart arrest and beating heart groups. BIS for monitoring depth of anesthesia was applied to operations of patients in the heart arrest and beating heart groups to guide anesthetic dosage. Observation points were set before anesthesia （T0）, 5 min after intubation （T1）, skin incision （T2）, 2 min after CPB （T3）, nasal temperature valley value （T4）, 5 rain after the shutdown of CPB （T5） and the end of operations （T6）. Then the hemodynamic indexes of CVP, MAP, and HR at each point were recorded, and the BIS values of both groups were recorded too. Results. Hemodynamics in the heart arrest and beating groups with BIS monitoring the depth of anesthesia was more stable than that in the non BIS group （P〈0.05）, but there was no significant difference between the heart arrest and beating heart groups （P〉0. 05）. Conclusion： Under BIS monitoring in guiding anesthesia medication to control the depth of anesthesia, the hemodynamics is more stable, the open-heart operations in heart arrest and beating heart groups can secure satisfactory anesthesia depth.

关 键 词：小儿心内直视手术 脑电双频指数 不停跳 

分 类 号：R614[医药卫生—麻醉学] R654.2[医药卫生—外科学]